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Common use of Dental Anesthesia Clause in Contracts

Dental Anesthesia. Benefits for general anesthesia and associated Hospital or ambulatory facility charges in conjunction with dental care provided to a Covered Person if the Covered Person: (A) Is a child seven years of age or younger or is developmentally disabled; ▪ Is an individual for whom a successful result cannot be expected from dental care provided under a local anesthesia because of a physical, intellectual, or other medically compromising condition; and ▪ Is an individual for whom a superior result can be expected from dental care provided under general anesthesia; or (B) Is an extremely uncooperative, fearful, or uncommunicative child who is 17 years of age or younger with dental needs of such magnitude that treatment should not be delayed or deferred; and ▪ Is an individual for whom lack of treatment can be expected to result in oral pain, infection, loss of teeth, or other increased oral or dental morbidity. Such services must be provided under the direction of a Physician or dentist. Benefits are not provided for expenses for the diagnosis or treatment of dental disease.

Appears in 9 contracts

Samples: Individual Exchange Medical Policy, Individual Exchange Medical Policy, Individual Exchange Medical Policy