23 Miss. Code. R. 204-2.3 - Surgical Extractions

A. The Division of Medicaid defines an impacted tooth as one where its eruption is partially or wholly obstructed by bone, soft tissue or other teeth.

B. The Division of Medicaid covers surgical extractions and removal of impacted teeth.

C. The Division of Medicaid does not cover for the extraction of an unerupted third molar unless medically necessary including, but not limited to:

1. Radiographic evidence that a third molar will be severely impacted, or

2. Evidence of infection.

D. The fee for all surgical extractions and removal of impacted teeth includes:

1. Local anesthesia,

2. Smoothing the socket site,

3. Suturing, and

4. Routine post-operative care.

Notes

23 Miss. Code. R. 204-2.3

Miss. Code Ann. § 43-13-121.

Revised eff 12/01/15; Amended 12/1/2015