Occlusal Orthotic Device (2022 Policy) PDF. Opens in a new window
Defines clinical/dental review guidance for occlusal orthotic devices (occlusal splints) used to reposition or stabilize the jaw for temporomandibular disorders (TMD) and control orofacial pain; explains dental review standards and that devices may be medical-plan covered or excluded from dental benefits depending on contract.
Policy status marked Revised; last review date 10/30/2021 and publish date 01/01/2022.
Coverage Summary
Defines clinical/dental review guidance for occlusal orthotic devices (occlusal splints) used to reposition or stabilize the jaw for temporomandibular disorders (TMD) and to control orofacial pain. Dental review is performed to ensure services meet generally accepted standards of dental practice and requires documentation. Coverage of these devices depends on the member's contract and dental plan exclusions; some TMD appliances may be considered medical in nature and are typically covered under medical plans.
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