MedicaidPrior AuthMedium impact
Provider Letter 2024-18: SoonerSelect Dental LIBERTY Changes
Oklahoma SoonerCare·OK · Dentistry, Oral & Maxillofacial Surgery·Provider Letter
Effective date
Oct 1, 2024
We identified it
Jun 20, 2026
Summary
LIBERTY Dental Plan is implementing new prior authorization requirements and documentation standards for impacted tooth removals (D7220, D7230, D7240), caries treatment (D1354), and caries risk assessments (D0601-D0603). Board certified oral surgeons are exempt from prior auth requirements but must maintain documentation for audits.
Action Required
By October 1, 2024: For LIBERTY Dental Plan SoonerSelect members only - Update billing workflow to obtain prior authorization for D7230 and D7240 procedures before treatment. For D7220 (when 2+ teeth same day) and D1354 (when 4+ permanent teeth same day), prepare required documentation including diagnostic x-rays, clinical notes, treatment plans, and photos for pre-payment review. Restrict D0601-D0603 billing to general dentists only - orthodontists cannot bill these codes. Board certified oral surgeons exempt from prior auth but must maintain documentation.