Dental

Dental

Form Update - Handicapping Labio-Lingual Deviation Index (HLD) Assessment

Effective July 1, 2022, the South Carolina Department of Health and Human Services (SCDHHS) is updating the Handicapping Labio-Lingual Deviation Index (HLD) Assessment form used for documenting the medical necessity of orthodontic services.

Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) - Orthodontic Services

The South Carolina Department of Health and Human Services (SCDHHS) will transition the administration of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) orthodontic services to its dental administrative services organization (DASO), DentaQuest, effective March 1, 2022. The transition will streamline administrative and payment processes by allowing dental providers to file prior authorization requests and claims to DentaQuest while receiving payment directly from SCDHHS. 

Upcoming Healthy Connections Medicaid Dental Provider Trainings - Fall 2021

The South Carolina Department of Health and Human Services (SCDHHS) regularly offers free trainings to prospective and enrolled Healthy Connections Medicaid providers. Many of these trainings are available virtually. Information about upcoming training opportunities for Healthy Connections Medicaid dental providers for fall 2021 is listed below.

SCDHHS Policy Updates for July 1, 2021

The South Carolina Department of Health and Human Services (SCDHHS) is announcing updates to several policies. The updates are described below and are effective for dates of service beginning July 1, 2021.  

Recognition of Licensed Addiction Counselors (LACs) as Licensed Practitioners of the Healing Arts (LPHAs)

Updates to the Dental Services Provider Manual

The South Carolina Department of Health and Human Services (SCDHHS) is issuing the following policy updates and clarifications for South Carolina Healthy Connections Medicaid dental providers effective for dates of service on and after Oct. 1, 2020.

Transition to Billing Current Dental Terminology (CDT) Procedure Codes

As part of its continued effort to streamline the claims filing and adjudication processes through the Medicaid Management Information System (MMIS) replacement effort, the South Carolina Department of Health and Human Services (SCDHHS) will transition dental providers from billing Current Procedural Terminology (CPT) procedure codes to Current Dental Terminology (CDT) procedure codes in 2020.

Temporary or Protective Restorative Services

Effective for services rendered on or after May 1, 2019, the South Carolina Department of Health and Human Services (SCDHHS) will no longer reimburse for Current Dental Terminology (CDT) code D2940 (Protective Restoration) as a separate service. Reimbursement rates for restorative services will include the costs of providing temporary or protective fillings as a component of permanent restorative care.

For questions regarding this bulletin, please contact the DentaQuest Provider Service Center at (888) 307-6553.

Dental Providers

Effective for dates of service on and after Jan. 1, 2019, the South Carolina Department of Health and Human Services (SCDHHS) will limit reimbursement for moderate sedation or deep sedation/general anesthesia ("sedation services") in dental offices to providers with a sedation permit from the State Board of Dentistry. For sedation services in a dental office to be reimbursed, a valid dental sedation permit must be on file with DentaQuest, and both the authorized office location and administering provider must be clearly documented in the patient's record. 

Dental Office Reference Manual Updates for October 2018

The South Carolina Department of Health and Human Services (SCDHHS) encourages all dental providers to review the latest updates on the SCDHHS Dental Office Reference Manual (ORM) effective on or after Oct. 1, 2018. The following existing policies have been updated:

1. Criteria for authorization of services delivered in an outpatient setting: operating room (OR) and ambulatory surgical center (ASC). 

To review this update please reference sections 3.03; 4.16; C.04 and exhibits A-C (Adjunctive Services cover page) of the Dental ORM.

Dental Manual Updates

The South Carolina Department of Health and Human Services (SCDHHS) is issuing the following dental policy updates, effective July 1, 2018.

1. Request for Reconsideration: SCDHHS and DentaQuest will refer to the former claim appeals process as the request for reconsideration process. The process itself remains the same and no changes or additional actions are required from providers. DentaQuest will reference the request for reconsideration in future communications. 

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