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Reminder for Medical Necessity for Dental Imaging and Limitations for Occlusal Radiographs pdf

Connecticut Medicaid (HUSKY Health)·CT · Dentistry, Oral & Maxillofacial Surgery·Provider Bulletin
Effective date
Aug 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (HUSKY Health) is implementing new frequency limits for occlusal radiographs (D0240) effective August 1, 2021. Most dental providers are limited to one occlusal radiograph per arch per member every two years, while oral radiologists and oral surgeons can take up to three per visit annually for specific conditions.

Action Required

Action needed
Immediately: Dental billing teams must update systems to enforce frequency limits for D0240 - limit to one per arch per member every two years for most providers, three per visit annually for oral radiologists/surgeons evaluating fractures, unerupted teeth, foreign bodies, tumors, or cysts. Update encounter forms to remind providers of documentation requirements. Claims exceeding limits without prior authorization will be denied.

Affected Billing Codes

D0240