ADA Dental Code List Microsoft
055366 (07-09-2021) An Independent Licensee of the Blue Cross Blue Shield Association . D0350 2D oral/facial photographic image obtained intra-orally or extra-orally N/A Not covered – unless billed for orthodontia work up and orthodontia benefit are available. Provider will need to indicate if taken for orthodontia.
Blue, Independent, Licensee, An independent licensee of the blue
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Questionnaire, Members, Home, Version, Incident, Incident questionnaire, Member version
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Request, Dependent, Certifications, Disabled, Request for certification of disabled dependent
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Policy, Guidelines, Management, Medical, Pharmacy, Utilization, Pharmacy policy, Or utilization management guideline
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www.premera.comiii immediately remove the drug from our formulary and provide notice to members who take the drug. Other changes. We may make other changes that affect members currently taking a drug.
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Laboratory, Reference, Medicare, Modifiers, Estudio, Modifier 90 reference
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www.premera.comPage | 2 of 19 ∞ Type of Therapy Medical Necessity Physical medicine and rehabilitation — physical therapy (PM&R – PT) Physical medicine and rehabilitation — physical therapy (PM&R – PT), including medical massage therapy services — may be considered medically necessary when ALL of the
Rehabilitation, Medicine, Physical, Therapy, Physical medicine and rehabilitation physical, Physical medicine and rehabilitation physical therapy
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