Medical, Dental & Pharmacy
- Medical
- Ambulatory Surgical Services
- Children's Services
- Chiropractic
- Clinic Services
- Community First Services and Supports (CFSS)
- Early Intensive Development and Behavioral Intervention (EIDBI)
- Equipment and Supplies
- HCBS
- Hearing Services
- Home Care Services
- Hospice Services
- Hospital Services
- Housing Stabilization Services
- Immunizations and Vaccinations
- Laboratory/Pathology, Radiology, and Diagnostic Services
- Language Interpreter Services
- Long-Term Care
- Medication Reconciliation
- Mental Health Services
- Optical Services
- Personal Care Assistance (PCA) Services
- Physician and Professional Services
- Recuperative Care
- Rehabilitation Services
- Renal Dialysis
- Restricted Recipient Program
- School-Based Community Services
- Substance Use Disorder
- Telehealth Services
- Transportation
- Tribal and Federal Indian Health Services
- Dental
- Pharmacy
Temporomandibular Joint Disorder (TMD)
TMD treatment is considered a medical service when the underlying pain and dysfunction is caused by 1) pain related to TMD, including myalgia, myofascial pain, arthralgia, arthritis, or headache attributed to TMD or 2) temporomandibular joint (TMJ) intra-articular disorders, including disk displacement with and without reduction, degenerative joint disease, osteoarthritis, or subluxation. Document that the history and physical exam support the diagnosis. The dentist must determine the underlying cause in order to accurately bill TMD services.
Medical Service Authorizations must be submitted. The ICD-10 diagnosis code and the associated CPT code for the occlusal orthotic device (41899 unlisted procedure, dentoalveolar structures) must be included on the authorization request.
If dental in nature, the dentist must bill ADA CDT procedure codes; if medical in nature, bill medical CPT procedure codes.
PW_11-18_439
Updated_11/01/2018
