Attention: Orthodontic Providers Update to Notice of Change in the Orthodontic Prior Approval Process

To correct problems with NCTracks regarding payment of the panoramic films rendered as part of the orthodontic records claim, CSC will grant prior approval of orthodontic records. Approval for the orthodontic records will be granted regardless of the outcome of the review (approval or denial) as long as the recipient has not exceeded the once per lifetime policy limit for orthodontic records.

Effective immediately, orthodontic records rendered on or after May 1, 2014 should be included on the request for orthodontic prior approval. Providers should include orthodontic record procedure codes D0330, D0340, D0470, and D8080. Do not include codes D0150 or D8670. Procedure code D8670 will be added by CSC Prior Approval Staff for cases that are approved for orthodontic services.

In addition, effective immediately, the date of service for the orthodontic records should be included. Providers should enter the date of service in the "Request Begin Date" field on the provider portal. If submitted via mail or fax, the date of service should be included on the ADA claim form in field 24 (Procedure Date.)