Dental

Dental

Adult Emergency Dental Service

Dental claims for adult extractions with a date of service on or after April 1, 2014 must include the word “EMERGENCY” on the claim form in field 35 (comments section). Additionally, pre-payment review is required for more than four (4) extractions per member per date of service. Providers are required to document the medical necessity for the emergency services in the patient’s medical record and submit this documentation along with the claim to DentaQuest, who will review the submitted documentation prior to paying for the service(s).  Prior authorization is optional.

EPSDT Policy Clarification

The South Carolina Department of Health and Human Services (SCDHHS) is issuing this bulletin for guidance on the provision of medically necessary dental services to children under the age of 21.

Preferred Drug List Update, Exceptions to Prescription Limit, Update to Synagis® (palivizumab) Reimbursement, Preferred Brand Medications and Certificate of Medical Necessity for Home Infusion Pharmacies

I. Preferred Drug List Update

The following revisions to the South Carolina Department of Health and Human Services (SCDHHS) Preferred Drug List (PDL) are effective with dates of service on or after January 1, 2014:

 

ANTIPARASITICS, TOPICAL

Preferred

Non-Preferred

PERMETHRIN, OTC†

CMS National Provider Call July 23: EHR Incentive Program: Overview of EP CQM Beginning 2014

 

 Medicare and Medicaid EHR Incentive Programs for Eligible Professionals: In-depth Overview of Clinical Quality Measures for Reporting Beginning in 2014 - Registration Now Open

Tuesday, July 23; 1:30-3pm ET

 

South Carolina Medicaid Preferred Drug List

 

The following revisions to the Preferred Drug List (PDL) are effective with dates of service on or after July 22, 2013. 

LAXATIVES & CATHARTICS

Preferred

Non-Preferred

National Provider Call: Stage 1 of the Medicare & Medicaid EHR Incentive Programs for EPs

 

National Provider Call: Stage 1 of the Medicare & Medicaid EHR Incentive Programs for Eligible Professionals: First in a Series — Registration Now Open

Thursday May 30; 1:30-3 PM ET

South Carolina Department of Health and Human Services Hosts Dental Services Open Forum

The South Carolina Department of Health and Human Services will host an open forum to receive input on the administration and management of the Medicaid dental program. The current Administrative Services contract with DentaQuest will expire on June 7, 2014.

This meeting will be held Friday, March 15, 2013 from 1:00 p.m. to 3:00 p.m.at the Blue Cross Blue Shield of South Carolina facility on Farrow Road.

CDT Coding Changes for Topical Application of Fluoride

 

Effective for dates of service on or after January 1, 2013, the following procedure codes will no longer be accepted by the South Carolina Department of Health and Human Services (SCDHHS).

South Carolina Medicaid Preferred Drug List

 

The following revisions to the Preferred Drug List (PDL) are effective with dates of service on or after January 1, 2013.

 

ANTIDEPRESSANTS, OTHER

Preferred

Non-Preferred

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