Molina Healthcare of Kentucky policy
Criteria for Oral and Maxillofacial Surgery Effective Date June 8, 2026
Criteria for Oral and Maxillofacial Surgery Effective Date June 8, 2026 is a public Molina Healthcare of Kentucky policy (effective Jun 8, 2026). It lists 7 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
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- Effective
- Jun 8, 2026
- Line of business
- Medicaid
- States
- KY
- Source
- www.molinahealthcare.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.
| Code | Other Molina Healthcare of Kentucky policies |
|---|---|
| D7220 | Policies naming D7220 |
| D7230 | Policies naming D7230 |
| D7240 | Policies naming D7240 |
| D7241 | Policies naming D7241 |
| D7280 | Policies naming D7280 |
| D7283 | Policies naming D7283 |
| D7880 | Policies naming D7880 |
All Molina Healthcare of Kentucky policies · Molina Healthcare of Kentucky prior authorization CPT list