Dental emergencies - prior authorization requirement for general anesthesia or intravenous sedation suspended temporarily

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Apple Health (Medicaid) Provider Alert

Effective for claims with dates of service March 18, 2020, through April 30, 2020, the Health Care Authority (HCA) is suspending prior authorization requirements for general anesthesia and intravenous sedation (CDT codes D9222, D9223, D9239, and D9243) when the client is experiencing a dental emergency. This decision is in response to COVID 19 and in an effort to keep dental emergencies out of hospital emergency departments.

When billing for general anesthesia or intravenous sedation related to dental emergencies, providers must include expedited prior authorization (EPA) number 870001607 on the claim form.

HCA still requires prior authorization for nonemergency oral surgeries.