PrimeWest Health policy
Medical, Dental & Pharmacy > Dental > Submitting Dental Service Authorization Requests
Medical, Dental & Pharmacy > Dental > Submitting Dental Service Authorization Requests is a public PrimeWest Health policy (policy PW_11-19_607, effective May 10, 2024). It lists 2 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
- Payer
- PrimeWest Health
- Policy number
- PW_11-19_607
- Effective
- May 10, 2024
- Line of business
- Medicaid
- States
- MN
- Source
- www.primewest.org
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes.
| Code | Other PrimeWest Health policies |
|---|---|
| D4341 | Policies naming D4341 |
| D4342 | Policies naming D4342 |