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Current Dental Terminology (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright © 2015 American Dental Association. The CDT Code and Nomenclature above have been obtained from Current Dental Terminology (including procedure codes, nomenclatures, descriptors and other data contained therein) ("CDT"). CDT is copyright © 2015 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.
On this page is a compilation of the obsolete pages as they correspond to the revision date. Click on a date to see the manual chapter page(s) prior to the revision.
Pages replaced from 05/16/2024 revision - Title Page
Pages replaced from 05/16/2024 revision - Table of Contents
Pages replaced from 05/16/2024 revision - Section 16.0 – Overview
Pages replaced from 10/06/2023 revision - Section 16.1 - Dental Programs - Provider Requirements
Pages replaced from 10/06/2023 revision - Section 16.2 - Dental Programs - Claims Related Information
Pages replaced from 10/06/2023 revision - Section 16.3 Beneficiary Eligibility Requirements
Pages replaced from 10/06/2023 revision - Section 16.4 – Securing Services
Pages replaced from 10/06/2023 revision - Section 16.5 - Covered Services
Pages replaced from 10/06/2023 revision - Section 16.6 – Non-covered Services
Pages replaced from 10/06/2023 revision - Section 16.7 – Prior Authorization
Pages replaced from 10/06/2023 revision - Section 16.8 - Beneficiary Eligibility Requirements
Pages replaced from 10/06/2023 revision - Section 16.9 - Covered Services
Pages replaced from 10/06/2023 revision - Section 16.10 – Non-covered Services
Pages replaced from 10/06/2023 revision - Section 16.11 – Prior Authorization
Pages replaced from 10/06/2023 revision - Appendix A – EPSDT Dental Program Fee Schedule
Pages replaced from 10/06/2023 revision - Appendix B – Adult Denture Program Fee Schedule
Pages replaced from 10/06/2023 revision - Appendix C – Dental Claim Form and Instructions
Pages replaced from 10/06/2023 revision - Appendix D – Adjustment/Void Forms and Instructions
Pages replaced from 10/06/2023 revision - Appendix E – Dental Periodicity Schedule
Pages replaced from 10/06/2023 revision - Appendix F – Claim Denial Simplification Process
Pages replaced from 10/06/2023 revision - Appendix G - Prior Authorization Sample Checklist
Pages replaced from 10/06/2023 revision - Appendix H – Prior Authorization Sample Letter
Pages replaced from 10/06/2023 revision - Appendix I - Forms
Pages replaced from 10/06/2023 revision - Appendix J – Contact/Referral Information
Pages replaced from 09/05/2023 revision - Appendix A – EPSDT – Fee Schedule
Pages replaced from 08/30/2023 revision - Appendix A – EPSDT – Fee Schedule
Pages replaced from 08/30/2023 revision - Appendix B – Adult Denture – Fee Schedule
Pages replaced from 02/08/2022 revision - 16.5 – EPSDT – Covered Services
Pages replaced from 02/08/2022 revision - Appendix A – EPSDT – Fee Schedule
Pages replaced from 07/16/2021 revision - Table of Contents
Pages replaced from 07/16/2021 revision - Appendix G – Prior Authorization Checklist
Pages replaced from 07/16/2021 revision - Appendix H – Prior Authorization Sample Letter
Pages replaced from 05/26/2021 revision - Appendix A – EPSDT – Fee Schedule
Pages replaced from 05/19/2021 revision - 16.0 – Overview
Pages replaced from 05/19/2021 revision - 16.1 – Provider Requirements
Pages replaced from 05/19/2021 revision - 16.2 – Claims Related Information
Pages replaced from 05/19/2021 revision - 16.3 – EPSDT – Beneficiary Eligibility
Pages replaced from 05/19/2021 revision - 16.4 – EPSDT – Securing Services
Pages replaced from 05/19/2021 revision - 16.5 – EPSDT – Covered Services
Pages replaced from 05/19/2021 revision - 16.7 – Prior Authorization
Pages replaced from 05/19/2021 revision - 16.8 – Adult Denture – Beneficiary Eligibility
Pages replaced from 05/19/2021 revision - 16.9 – Adult Denture – Covered Services
Pages replaced from 05/19/2021 revision - 16.11 – Adult Denture Prior Authorization
Pages replaced from 05/19/2021 revision - Appendix A – EPSDT – Fee Schedule
Pages replaced from 05/19/2021 revision - Appendix B – Adult Denture Fee Schedule
Pages replaced from 05/19/2021 revision - Appendix C – Dental Claim Form Instructions
Pages replaced from 05/19/2021 revision - Appendix D – Adjustment-Void Forms and Instructions
Pages replaced from 05/19/2021 revision - Appendix F – Claim Denial Simplification Process
Pages replaced from 05/19/2021 revision - Appendix J – Contact Referral Information
Pages replaced from 07/01/2020 revision - 16.5 – EPSDT Covered Services
Pages replaced from 07/01/2020 revision - Appendix B – Adult Denture Fee Schedule
Pages replaced from 07/01/2020 revision - Appendix C – Dental Claim Form Instructions
Pages replaced from 07/01/2020 revision - Appendix F – Claim Denial Simplification Process
Pages replaced from 05/15/2020 revision - Table of Contents
Pages replaced from 05/15/2020 revision - 16.0 – Overview
Pages replaced from 05/15/2020 revision - 16.1 – Provider Requirements
Pages replaced from 05/15/2020 revision - 16.2 – Claims Related Information
Pages replaced from 05/15/2020 revision - 16.3 – EPSDT – Beneficiary Eligibility
Pages replaced from 05/15/2020 revision - 16.4 – EPSDT – Securing Services
Pages replaced from 05/15/2020 revision - 16.7 – Prior Authorization
Pages replaced from 05/15/2020 revision - 16.8 – Adult Denture – Beneficiary Eligibility
Pages replaced from 05/15/2020 revision - 16.9 – Adult Denture Covered Services
Pages replaced from 05/15/2020 revision - 16.10 – Adult Denture Non-Covered Services
Pages replaced from 05/15/2020 revision - 16.11 – Adult Denture Prior Authorization
Pages replaced from 05/15/2020 revision - Appendix D – Adjustment-Void Forms and Instructions
Pages replaced from 05/15/2020 revision - Appendix E – Dental Periodicity Schedule
Pages replaced from 05/15/2020 revision - Appendix H – PA Sample Letter
Pages replaced from 05/15/2020 revision - Appendix J – Contact Referral Information
Pages replaced from 02/27/2019 revision - 16.5 EPSDT – Covered Services
Pages replaced from 02/12/2019 revision - 16.5 EPSDT – Covered Services
Pages replaced from 02/06/2019 revision - 16.5 EPSDT – Covered Services
Pages replaced from 11/27/2018 revision - 16.5 EPSDT – Covered Services
Page replaced from 06/09/2017 revision – Title Page
Page replaced from 06/09/2017 revision – 16.1 - Provider Requirements
Page replaced from 06/09/2017 revision – 16.5 - EPSDT – Covered Services
Page replaced from 06/09/2017 revision – 16.7 - EPSDT – Prior Authorization
Page replaced from 06/09/2017 revision – 16.8 - Adult Denture Program – Recipient Eligibility Requirements
Page replaced from 06/09/2017 revision – 16.9 - Adult Denture Program – Covered Services
Page replaced from 06/09/2017 revision – 16.11 - Adult Denture Program – Prior Authorization
Page replaced from 06/09/2017 revision – Appendix G - Prior Authorization Checklist
Page replaced from 06/09/2017 revision – Appendix I - Forms
Page replaced from 06/09/2017 revision – Appendix J - Frequent Contact Information
Pages replaced from 05/24/2017 revision – Appendix E – Dental Periodicity Schedule
Pages replaced from 03/10/2016 revision – 16.0 - Overview
Pages replaced from 03/10/2016 revision – Appendix A - EPSDT Dental Program Fee Schedule
Pages replaced from 03/10/2016 revision – Appendix B – Adult Denture Program Fee Schedule
Page replaced from 09/25/2015 revision – Title Page
Pages replaced from 10/10/2014 revision – Appendix J – Contact Referral Info
Pages replaced from 08/18/2014 revision – Appendix A – EPSDT Dental Program Fee Schedule
Pages replaced from 08/18/2014 revision – Appendix B – Adult Denture Program Fee Schedule
Pages replaced from 09/15/2013 revision – 16.5 – EPSDT Covered Services
Pages replaced from 09/15/2013 revision – 16.7 – EPSDT Prior Authorization
Pages replaced from 09/15/2013 revision – 16.8 – Adult Denture Program Recipient Eligibility Requirements
Pages replaced from 09/15/2013 revision – Appendix A – EPSDT Dental Program Fee Schedule
Pages replaced from 09/15/2013 revision – Appendix B – Adult Denture Program Fee Schedule
Pages replaced from 09/15/2013 revision – Appendix E – Dental Periodicity Schedule
Pages replaced from 09/15/2013 revision – Appendix H – Prior Authorization Sample Letter
Pages replaced from 03/28/2013 revision – Appendix A – EPSDT Dental Program Fee Schedule
Pages replaced from 03/15/2013 revision – Table of Contents
Pages replaced from 03/15/2013 revision – 16.0 – Overview
Pages replaced from 03/15/2013 revision – 16.1 – Provider Requirements
Pages replaced from 03/15/2013 revision – 16.2 – Claims Related Information
Pages replaced from 03/15/2013 revision – 16.3 – EPSDT Recipient Eligibility
Pages replaced from 03/15/2013 revision – 16.4 – EPSDT Securing Services
Pages replaced from 03/15/2013 revision – 16.5 – EPSDT Covered Services
Pages deleted from 03/15/2013 revision – 16.12 – EDSPW-Recipient Eligibility Requirements
Pages deleted from 03/15/2013 revision – 16.13 – EDSPW-Covered Services
Pages deleted from 03/15/2013 revision – 16.14 – EDSPW-Non-Covered Services
Pages deleted from 03/15/2013 revision – 16.15 – EDSPW-Prior Authorization
Pages deleted from 03/15/2013 revision – Appendix C – EDSPW Program Fee Schedule
Pages deleted from 03/15/2013 revision – Appendix D – Dental Claim Form Instructions
Pages deleted from 03/15/2013 revision – Appendix E – Adjustment/Void Forms and Instructions
Pages deleted from 03/15/2013 revision – Appendix F – Dental Periodicity Process
Pages deleted from 03/15/2013 revision – Appendix G – Claim Denial Simplification Process
Pages deleted from 03/15/2013 revision – Appendix H – PA Checklist
Pages deleted from 03/15/2013 revision – Appendix I – PA Sample Letter
Pages replaced from 03/15/2013 revision – Appendix J – Forms
Pages deleted from 03/15/2013 revision – Appendix K – Contact Referral Info
Pages replaced from 09/15/2012 revision – Chapter 16 Section 16.5 EPSDT – Covered Services
Pages replaced from 09/15/2012 revision – Chapter 16 Appendix B – Adult Denture Fee Schedule
Pages replaced from 07/01/12 revision – Chapter 16 Appendix A – EPSDT Fee Schedule
Pages replaced from 07/01/12 revision – Chapter 16 Appendix B – Adult Denture Fee Schedule
Pages replaced from 07/01/12 revision – Chapter 16 Appendix C – EDSPW Fee Schedule
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