Kansas Administrative Regulations
Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES
Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM
Section 30-5-100 - Scope of dental services
Universal Citation: KS Admin Regs 30-5-100
Current through Register Vol. 43, No. 39, September 26, 2024
(a) Dental services shall be covered for recipients receiving a Kan Be Healthy dental screening.
(1) Both a Kan Be Healthy medical screening
and a Kan Be Healthy dental screening shall be required for coverage of limited
orthodontia services, with the exception of emergency services.
(2) Prior authorization shall be required for
designated services.
(3) Prior
authorization shall be required for dental treatment plans estimated to exceed,
during a calendar year, the range maximum established by the secretary.
(b) Dental services for medicaid recipients not participating in the Kan Be Healthy program shall be limited to the following treatments:
(1)
Orcantral fistula closure;
(2)
unilateral radical antrotomy;
(3)
biopsy of oral tissue;
(4) radical
excision of lesion;
(5) excision
of tumors;
(6) removal of cysts
and neoplasms;
(7) partial
ostectomy;
(8) surgical incision
and drainage of abscess;
(9)
removal of foreign bodies, skin, subcutaneous areolar tissue;
(10) sequestrectomy for osteomyelitis;
(11) maxillary sinusotomy for
removal of tooth fragment or foreign body;
(12) treatment of fractures;
(13) closed reduction of dislocation and
related injections;
(14)
limitation of motion and related injections;
(15) sutures;
(16) oral skin grafts;
(17) frenulectomy;
(18) excision of pericoronal gingiva;
(19) sialalithotomy;
(20) excision of salivary gland;
(21) sialodochoplasty;
(22) closure of salivary fistula;
(23) emergency tracheotomy;
(24) general anesthesia: first 30 minutes;
(25) general anesthesia: each
additional 15 minutes;
(26)
consultation in the form of diagnostic services provided by a dentist or
physician other than the practitioner providing treatment;
(27) house call or extended care facility
call;
(28) hospital call; and
(29) prior authorized procedures
for medically necessary tooth extractions.
(c) This regulation shall be effective on and after January 1, 2002.
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