Current through Register Vol. 24-18, September 15, 2024
Clients described in WAC
182-535-1060 are eligible to
receive the adjunctive general services listed in this section, subject to
coverage limitations, restrictions, and client-age requirements identified for
a specific service.
(1)
Adjunctive general services. The medicaid agency:
(a) Covers palliative (emergency) treatment,
not to include pupal debridement (see WAC
182-535-1086(2)(b)),
for treatment of dental pain, limited to once per day, per client, as follows:
(i) The treatment must occur during limited
evaluation appointments;
(ii) A
comprehensive description of the diagnosis and services provided must be
documented in the client's record; and
(iii) Appropriate radiographs must be in the
client's record supporting the medical necessity of the treatment.
(b) Covers local anesthesia and
regional blocks as part of the global fee for any procedure being provided to
clients.
(c) Covers office-based
deep sedation/general anesthesia services:
(i)
For all eligible clients age eight and younger and clients any age of the
developmental disabilities administration of the department of social and
health services (DSHS). Documentation supporting the medical necessity of the
anesthesia service must be in the client's record.
(ii) For clients age nine through 20 on a
case-by-case basis and when prior authorized, except for oral surgery services.
For oral surgery services listed in WAC
182-535-1094(1)(f) through
(l) and clients with cleft palate diagnoses,
the agency does not require prior authorization for deep sedation/general
anesthesia services.
(iii) For
clients age 21 and older when prior authorized. The agency considers these
services for only those clients:
(A) With
medical conditions such as tremors, seizures, or asthma;
(B) Whose records contain documentation of
tried and failed treatment under local anesthesia or other less costly sedation
alternatives due to behavioral health conditions; or
(C) With other conditions for which general
anesthesia is medically necessary, as defined in WAC
182-500-0070.
(d) Covers office-based intravenous moderate
(conscious) sedation/analgesia:
(i) For any
dental service for clients age 20 and younger, and for clients any age of the
developmental disabilities administration of DSHS. Documentation supporting the
medical necessity of the service must be in the client's record.
(ii) For clients age 21 and older when prior
authorized. The agency considers these services for only those clients:
(A) With medical conditions such as tremors,
seizures, or asthma;
(B) Whose
records contain documentation of tried and failed treatment under local
anesthesia, or other less costly sedation alternatives due to behavioral health
conditions; or
(C) With other
conditions for which general anesthesia or conscious sedation is medically
necessary, as defined in WAC
182-500-0070.
(e) Covers office-based nonintravenous
conscious sedation:
(i) For any dental
service for clients age 20 and younger, and for clients any age of the
developmental disabilities administration of DSHS. Documentation supporting the
medical necessity of the service must be in the client's record.
(ii) For clients age 21 and older, only when
prior authorized.
(f)
Requires providers to bill anesthesia services using the current dental
terminology (CDT) codes listed in the agency's current published billing
instructions.
(g) Requires
providers to have a current anesthesia permit on file with the
agency.
(h) Covers administration
of nitrous oxide once per day, per client per provider.
(i) Requires providers of oral or parenteral
conscious sedation, deep sedation, or general anesthesia to meet:
(i) The prevailing standard of
care;
(ii) The provider's
professional organizational guidelines;
(iii) The requirements in chapter 246-817
WAC; and
(iv) Relevant department
of health (DOH) medical, dental, or nursing anesthesia regulations.
(j) Pays for dental anesthesia
services according to WAC
182-535-1350.
(k) Covers professional
consultation/diagnostic services as follows:
(i) A dentist or a physician other than the
practitioner providing treatment must provide the services; and
(ii) A client must be referred by the agency
for the services to be covered.
(2)
Professional visits. The
agency covers:
(a) Up to two house/extended
care facility calls (visits) per facility, per provider. The agency limits
payment to two facilities per day, per provider.
(b) One hospital visit, including emergency
care, per day, per provider, per client, and not in combination with a surgical
code unless the decision for surgery is a result of the visit.
(c) Emergency office visits after regularly
scheduled hours. The agency limits payment to one emergency visit per day, per
client, per provider.
(3)
Drugs and medicaments (pharmaceuticals).
(a) The agency covers oral sedation
medications only when prescribed and the prescription is filled at a pharmacy.
The agency does not cover oral sedation medications that are dispensed in the
provider's office for home use.
(b)
The agency covers therapeutic parenteral drugs as follows:
(i) Includes antibiotics, steroids,
anti-inflammatory drugs, or other therapeutic medications. This does not
include sedative, anesthetic, or reversal agents.
(ii) Only one single-drug injection or one
multiple-drug injection per date of service.
(c) For clients age 20 and younger, the
agency covers other drugs and medicaments dispensed in the provider's office
for home use. This includes, but is not limited to, oral antibiotics and oral
analgesics. The agency does not cover the time spent writing
prescriptions.
(d) For clients
enrolled in an agency-contracted managed care organization (MCO), the client's
MCO pays for dental prescriptions.
(4)
Miscellaneous services. The
agency covers:
(a) Behavior management
provided by a dental provider or clinic. The agency does not cover assistance
with managing a client's behavior provided by a dental provider or staff member
delivering the client's dental treatment.
(i)
Documentation supporting the need for behavior management must be in the
client's record and including the following:
(A) A description of the behavior to be
managed;
(B) The behavior
management technique used; and
(C)
The identity of the additional professional staff used to provide the behavior
management.
(ii) Clients,
who meet one of the following criteria and whose documented behavior requires
the assistance of one additional professional staff employed by the dental
provider or clinic to protect the client and the professional staff from injury
while treatment is rendered, may receive behavior management:
(A) Clients age eight and younger;
(B) Clients age nine through 20, only on a
case-by-case basis and when prior authorized;
(C) Clients any age of the developmental
disabilities administration of DSHS;
(D) Clients diagnosed with autism;
(E) Clients who reside in an alternate living
facility (ALF) as defined in WAC
182-513-1301, or in a nursing
facility as defined in WAC
182-500-0075.
(iii) Behavior management can be performed in
the following settings:
(A) Clinics (including
independent clinics, tribal health clinics, federally qualified health centers,
rural health clinics, and public health clinics);
(B) Offices;
(C) Homes (including private homes and group
homes); and
(D) Facilities
(including nursing facilities and alternate living facilities).
(b) Treatment of
post-surgical complications (e.g., dry socket). Documentation supporting the
medical necessity of the service must be in the client's record.
(c) Occlusal guards when medically necessary
and prior authorized. (Refer to WAC
182-535-1094(4)
for occlusal orthotic device coverage and coverage limitations.) The agency
covers:
(i) An occlusal guard only for
clients age 12 through 20 when the client has permanent dentition;
and
(ii) An occlusal guard only as
a laboratory processed full arch appliance.
(5)
Nonclinical procedures.
(a) The agency covers teledentistry according
to the department of health, health systems quality assurance office of health
professions, current guidelines, appropriate use of teledentistry, and as
follows (see WAC
182-531-1730 for coverage
limitations not listed in this section):
(i)
Synchronous teledentistry at the distant site for clients of all ages;
and
(ii) Asynchronous teledentistry
at the distant site for clients of all ages.
(b) The client's record must include the
following supporting documentation regarding teledentistry:
(i) Service provided via
teledentistry;
(ii) Location of the
client;
(iii) Location of the
provider; and
(iv) Names and
credentials of all persons involved in the teledentistry visit and their role
in providing the service at both the originating and distant sites.
Statutory Authority:
RCW
41.05.021. 12-09-081, §182-535-1098,
filed 4/17/12, effective 5/18/12. 11-14-075, recodified as §182-535-1098,
filed 6/30/11, effective 7/1/11. Statutory Authority:
RCW
74.08.090,
74.09.500,
74.09.520. 07-06-042, §
388-535-1098, filed 3/1/07, effective
4/1/07.