Dental Services for
Defines when non-routine dental care for injuries to sound natural teeth is covered under the member's medical benefit for Blue Cross & Blue Shield of Rhode Island (commercial products and BlueCHiP for Medicare) and lists covered procedures, relevant diagnosis codes, and billing guidance. Prior authorization is not required.
Policy last updated 11/21/2017; no clinical policy statement changes indicated in document.
Coverage Summary
Medical benefit covers initial dental care for injuries to sound natural teeth caused by accidental trauma, limited to emergency/trauma procedures such as suturing, extractions to avoid infection, reimplantation/stabilization, dental X‑rays, and repositioning/stabilization. Coverage typically applies when treatment is received in hospital or emergency room settings but benefits may vary by contract and the member’s Benefit Booklet or Evidence of Coverage should be consulted. Prior authorization is not required.
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