Summary
Michigan Medicaid is adding coverage for CDT code D1354 (Interim Caries Arresting Medicament Application) using Silver Diamine Fluoride effective January 1, 2017. This new dental benefit allows up to 6 applications per lifetime with specific billing limitations and informed consent requirements.
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What to do
Action · 4 steps
01Before January 1, 2017: Dental billing team must add CDT code D1354 to billing system for Michigan Medicaid patients.
02Update system rules to limit billing to once per date of service (maximum 5 teeth per visit) with lifetime limit of 6 applications.
03Ensure D1354 cannot be billed same day as other fluoride applications.
04Providers must obtain signed informed consent before treatment and document medical necessity when traditional treatments are contraindicated.
Codes mentioned
D1354
Original notice
MSA 16-38
michigan.gov · Always check the source before changing claims.