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Elizabeth M. Whitehorn, Director

Provider Notice Issued 06/13/2018

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Date:     June 13, 2018

 

To:        Enrolled Dental Providers

 

Re:       Addition of Current Dental Terminology (CDT) D1354 - Interim Caries Arresting Medicament Application  

 

 

This notice informs providers that effective with dates of service on and after July 1, 2018, CDT code D1354 Interim Caries Medicament will be a covered fee-for-service dental benefit for all ages.

 

Providers may treat a maximum of 4 teeth per day, providing participant has  no history of any prior or same day billing of CDT category D2000 (Restorative codes) or CDT category D3000 (Endodontic codes) on the same tooth. In addition, providers can provide a maximum of two applications a year per tooth with a lifetime maximum of six applications of medicament per tooth.

 

A revised dental fee schedule can be found on the Illinois Department of Healthcare and Family Services website.

 

For questions regarding this notice, please contact your provider representative or the Department’s Bureau of Professional and Ancillary Services at 877-782-5565.

 

Felicia F. Norwood

Director