Pre-Treatment Procedure

Update on Pre-Treatment Authorizations (Jan. 1, 2014)

We are pleased to announce that prior authorization on restorative fillings is no longer required. Please review the codes below to ensure that you DO NOT submit pre authorization on the following treatments.

Codes: D2140, D2150, D2160, D2330, D2331, D2332, D2335, D2391, D2392, D2393

Electronic Pre-Treatment

Submit electronically (Payer ID: fcl) (NEA:000000) or via postal for pre-treatment authorization. Include appropriate member information, clinical findings and radiographic support. Please allow 14 days for review and processing.

• PPO
• Medicare Advantage Members

Pre-Treatment is NOT required for the following:

• Preventive
• Diagnostic
• Emergency treatment
• Patients who present a specific symptomatic problem and/or dental emergency such as trauma or acute infection