Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 204 - Dental Services
Chapter 2 - Oral Surgery
Rule 23-204-2.4 - Alveoloplasty
Universal Citation: MS Code of Rules 23-204-2.4
Current through September 24, 2024
The Division of Medicaid covers alveoloplasty as a separate procedure from extractions or in conjunction with extractions when there is a need for significant bone re-contouring in the quadrant to prepare the ridge for a prosthetic appliance if there:
A. Are three (3) or more tooth spaces present per quadrant, or three (3) or more teeth extracted per quadrant, or
B. Are less than three (3) tooth spaces present per quadrant, or less than three (3) teeth extracted per quadrant if prior authorized as medically necessary by the Utilization Management/Quality Improvement Organization (UM/QIO), or designee.
Miss. Code Ann. § 43-13-121.
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