Oral Surgery. We Cover non-routine oral surgery, such as partial and complete bony extractions, tooth re-implantation, tooth transplantation, surgical access of an unerupted tooth, mobilization of erupted or malpositioned tooth to aid eruption, and placement of device to facilitate eruption of an impacted tooth. We also Cover oral surgery in anticipation of, or leading to orthodontics that are otherwise Covered under this Contract.
Oral Surgery. Extractions, including those provided in conjunction with orthodontic services; Cutting procedures; Treatment of fractures and dislocations of the jaw.
Oral Surgery. Benefits include:
A. Medically Necessary procedures, as determined by CareFirst BlueChoice, to attain functional capacity, correct a congenital anomaly (excluding odontogenic congenital anomalies or anomalies limited to the teeth), reduce a dislocation, repair a fracture, excise tumors, non-odontogenic cysts or exostoses, or drain abscesses involving cellulitis and are performed on the lips, tongue, roof, and floor of the mouth, sinuses, salivary glands or ducts, and jaws. SAMPLE
B. Medically Necessary procedures, as determined by CareFirst BlueChoice, needed as a result of an accidental injury, when the Member requests oral surgical services or dental services for Sound Natural Teeth and supporting structures or the need for oral surgical services or dental services for Sound Natural Teeth and supporting structures is identified in the patient’s medical records within sixty (60) days of the accident. Benefits for such oral surgical services will be provided up to three (3) years from the date of injury.
C. Surgical treatment for temporomandibular joint syndrome (TMJ) if there is clearly demonstrable radiographic evidence of joint abnormality due to an illness. All other procedures involving the teeth or areas surrounding the teeth including the shortening of the mandible or maxillae (orthognathic surgery) for Cosmetic or other purposes or for correction of the malocclusion unrelated to a functional impairment that cannot be corrected non-surgically are excluded.
Oral Surgery. Surgical extractions and other oral surgical procedures which are dentally necessary and meet our dental policies and related guidelines are covered only if the oral surgery is not a covered service under your medical insurance plan. General anesthesia is covered only when rendered in conjunction with a covered oral surgical procedure.
Oral Surgery. Benefits include:
A. Medically Necessary procedures, as determined by CareFirst, to attain functional capacity, correct a congenital anomaly (excluding odontogenic congenital anomalies or anomalies limited to the teeth), reduce a dislocation, repair a fracture, excise tumors, non- odontogenic cysts or exostoses, or drain abscesses involving cellulitis and are performed on the lips, tongue, roof, and floor of the mouth, sinuses, salivary glands or ducts, and jaws.
B. Medically Necessary procedures, as determined by CareFirst, needed as a result of an accidental injury, when the Member requests oral surgical services or dental services for Sound Natural Teeth and supporting structures or the need for oral surgical services or dental services for Sound Natural Teeth and supporting structures is identified in the patient’s medical records within sixty (60) days of the accident. Benefits for such oral surgical services will be provided up to three (3) years from the date of injury.
C. Surgical treatment for temporomandibular joint syndrome (TMJ) if there is clearly demonstrable radiographic evidence of joint abnormality due to an illness. All other procedures involving the teeth or areas surrounding the teeth including the shortening of the mandible or maxillae (orthognathic surgery) for Cosmetic or other purposes or for correction of the malocclusion unrelated to a functional impairment that cannot be corrected non-surgically are excluded.
Oral Surgery. Benefits include: SAMPLE
A. Medically Necessary procedures, as determined by CareFirst BlueChoice, to attain functional capacity, correct a congenital anomaly (excluding odontogenic congenital anomalies or anomalies limited to the teeth), reduce a dislocation, repair a fracture, excise tumors, non-odontogenic cysts or exostoses, or drain abscesses involving cellulitis and are performed on the lips, tongue, roof, and floor of the mouth, sinuses, salivary glands or ducts, and jaws.
B. Medically Necessary procedures, as determined by CareFirst BlueChoice, needed as a result of an accidental injury, when the Member requests oral surgical services or dental services for Sound Natural Teeth and supporting structures or the need for oral surgical services or dental services for Sound Natural Teeth and supporting structures is identified in the patient’s medical records within sixty (60) days of the accident. Benefits for such oral surgical services shall be provided up to three (3) years from the date of injury.
C. Medically Necessary surgical treatment, as determined by CareFirst BlueChoice, for Temporomandibular Joint Syndrome (TMJ). Except as provided in Section 2, Pediatric Dental Services, all other treatments or procedures for the treatment of TMJ are excluded. All other procedures involving the teeth or areas surrounding the teeth including the shortening of the mandible or maxillae for Cosmetic purposes or for correction of malocclusion unrelated to a functional impairment are excluded.
Oral Surgery. Benefits for oral surgery include root recovery, surgical exposure of impacted or unerupted teeth, fractures and dislocations of the face or jaw, surgical excisions (e.g., cysts, tori, exostosis), dental implants for the treatment of oral cancer and cancer of the esophagus, and lingual frenulum repairs under certain conditions. Orthognathic surgery is limited to conditions resulting in significant functional impairment, or for the treatment of congenital birth defects in newborns, as required by law. Anesthesia charges associated with oral surgery are covered for an eligible dental patient when determined by Keystone to be Medically Necessary and when a successful result cannot be expected for treatment under local anesthesia and for whom a superior result can be expected under general anesthesia. An eligible dental patient is a patient who is seven years of age or younger or developmentally disabled. Anesthesia and all related benefits for an eligible dental patient are subject to all applicable cost-sharing amounts.
Oral Surgery. You will receive the highest level of Benefits when You go to a Provider who is in the Blue Cross and Blue Shield of Louisiana’s dental network. For a copy of the directory for the dental network, go to xxx.xxxxxx.xxx, or call the Customer Service telephone number on Your ID card. Your Plan covers only the following Oral Surgery services or procedures.
1. Excision of tumors or cysts (not odontogenic cysts) of the jaws, gums, cheeks, lips, tongue, roof, and floor of mouth.
2. Anesthesia for the above services or procedures when given by an oral surgeon, or by a dentist who holds all required permits or training to administer anesthesia.
3. Anesthesia when given in a Hospital setting and for associated Hospital charges when Your mental or physical condition requires Covered Services to be given in a Hospital setting. Your Plan does not pay for Anesthesia to treat Temporomandibular Joint (TMJ) Disorders.
4. Your Plan pays for dental services that are not otherwise covered when the services are specifically required for head and neck cancer patients. Benefits are limited to preparation for or follow-up to radiation therapy involving the mouth. To find out if You qualify for these Benefits, call Customer Service at the phone number on Your ID card, and ask to speak to a Case Manager.
Oral Surgery. This is routine surgery involving teeth or alveolar bone, including extraction and alveolectomy. Oral surgery may include other oral treatment and surgery, if a dentist considers it dentally necessary. Oral surgery does not include orthodontia, orthognathic surgery, placement of dental implants or surgical care that is necessary because of a medical condition.
Oral Surgery. Amalgam, silicate, acrylic, synthetic porcelain, and composite filling restorations to restore diseased or accidentally broken teeth.
