23 Miss. Code. R. 204-2.4 - Alveoloplasty
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.
Notes
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No prior version found.