Dental - Change In How to Check for Available Units for CDT Codes

Attention Dental providers:

The Health Care Authority (HCA) has discovered that the Client Limit Inquiry feature in ProviderOne is not able to calculate available units for CDT® procedure codes that require an arch or quadrant designation as required in the Dental Services Billing Guide. Examples of these are CDT® codes D4341 and D4210.

If you need to check available limits for CDT® codes that require an arch or quadrant designation, use one of the following options:

• Use the Secure Contact Us web form, or
• If the date of service is within 48 hours, call HCA’s Medical Assistance Customer Service Center (MACSC) at 1-800-562-3022, choose “provider services,” and follow the prompts. All other requests must use the Secure Contact Us web form.

Note: When you are filling out the Secure Contact Us web form, make sure to select the topic Service Limits to ensure prompt processing.

CDT® codes and descriptions only are copyright 2021 American Dental Association