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The Regence Group Dental Policy
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Orthodontics Section - Replacement of Lost or Broken Retainer

Topic: Replacement of Lost or Broken Retainer Last Reviewed Date:  01/2003
Section: Orthodontics Policy No: 54B
Revised/Effective Date: 01/2003 Next Review Date: 01/2004


IMPORTANT INFORMATION
This Dental Policy has been developed through consideration of generally accepted standards of dental practice, review of dental literature, dental necessity, and as appropriate, government approval.

Benefit determinations should be based in all cases on the applicable contract language. To the extent there are any conflicts between these guidelines and the contract language, the contract language will control.

The purpose of dental policy is to provide a guide to coverage. Dental policy is not intended to dictate to providers how to practice dentistry. Providers are expected to exercise their clinical judgment in providing the most appropriate care.


Description
Replacement of lost or broken retainer (D8692)

Policy/Criteria

Procedure is in accordance with generally accepted standards of dental practice.

Administrative Guidelines
Process to orthodontic benefit.

  • Not a covered benefit if there is a contract exclusion for lost or stolen appliances.
Codes Number Description
CDT
D8000-D8999  

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