MedicaidCoverageMedium impact
Attention Provider Type 22 (Dentist): Alveoloplasty Benefits Available for Members Under the Intellectual and Developmental Disabilities Waiver and Service Limitations Updated
Nevada Medicaid·NV · Dentistry, Oral & Maxillofacial Surgery·Provider Enrollment
Effective date
Oct 6, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has expanded alveoloplasty benefits to include members under the Intellectual and Developmental Disabilities Waiver and updated service limitations for dental codes D7310, D7311, D7320, and D7321. These procedures are now limited to 1 unit per quadrant per lifetime, with specific same-day billing restrictions and updated error codes.
Action Required
Effective October 6, 2025: Dental billing teams must update billing systems to enforce lifetime limits of 1 unit per quadrant for codes D7310, D7311, D7320, and D7321. Configure system to prevent same-day billing of D7310 with D7311 or D7320 with D7321 for the same quadrant. Update prior authorization requirements for IDD Waiver members seeking alveoloplasty services. Claims exceeding limitations will deny with error codes 5511 or 6136.