Endodontics. We Cover routine endodontic services, including procedures for treatment of diseased pulp xxxxxxxx and pulp canals, where Hospitalization is not required. In those members age 21 and over, molar endodontic therapy will be considered only in those instances where the tooth in question is a critical abutment for an existing functional prosthesis and when the tooth cannot be extracted and replaced with a new prosthesis, or, where there is a documented medical condition which precludes extraction.
Appears in 4 contracts
Samples: Preferred Provider, Preferred Provider, Preferred Provider Organization Contract
