Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 202 - Hospital Services
Chapter 5 - Hospital Procedures
Rule 23-202-5.7 - Dental Services Provided in a Hospital Setting
Universal Citation: MS Code of Rules 23-202-5.7
Current through September 24, 2024
A. The Division of Medicaid covers medically necessary dental treatment in the outpatient hospital setting when all the following are met:
1. Quality, safe, and effective treatment
cannot be provided in an office setting,
2. Inpatient hospitalization is not medically
necessary [Refer to Miss. Admin. Code Part 204, Rule
1.11.B.], and
3. Certain dental procedures have been prior
authorized by the Division of Medicaid or designee.
B. The Division of Medicaid covers medically necessary dental treatment in the inpatient hospital setting when:
1. The beneficiary's age, medical or
psychological needs, and/or the extent of treatment necessitate
hospitalization, and
2. Prior
authorized by the Division of Medicaid or designee.
C. Hospital providers must bill the procedure code that accurately reflects the services rendered as follows:
1. Dental procedures performed by a
Mississippi licensed dentist must be billed with a Code on Dental Procedures
and Nomenclature (CDT).
2. Dental
procedures performed by a Mississippi licensed dentist who is also a
Mississippi licensed physician can bill either a CDT code or a Current
Procedural Terminology (CPT) code.
Miss. Code Ann. §§ 43-13-117, 43-13-121.
Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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