Clinical Policies

Comprehensive and Periodic Oral Evaluations (ENVD.UM.CP.0001 )
Problem Focused and Limited Oral Evaluations (ENVD.UM.CP.0002 )
EPSDT (ENVD.UM.CP.0003 )
Sealants (ENVD.UM.CP.0004 )
Orthodontic Treatment (ENVD.UM.CP.0005)
Non-Surgical Periodontics (ENVD.UM.CP.0006 )
Single Tooth Indirect Restorations (ENVD.UM.CP.0007 )
IV Moderate Sedation, IV Deep Sedation and General Anesthesia (ENVD.UM.CP.0009 )
Behavioral Guidance (ENVD.UM.CP.0010 )
Extraction of Impacted Teeth (ENVD.UM.CP.0011 )
New Technologies and New Uses of Existing Technologies (ENVD.UM.CP.0012 )
Cleft and Craniofacial Anomalies (ENVD.UM.CP.0013 )
Tobacco Counseling (ENVD.UM.CP.0014 )
Therapeutic Parenteral and Infiltrated Drugs in Dentistry (ENVD.UM.CP.0015 )
Dental Restorations (ENVD.UM.CP.0016 )
Pre-Fabricated Crowns (ENVD.UM.CP.0017 )
Prophylaxis (ENVD.UM.CP.0018)
Fluoride Treatment (ENVD.UM.CP.0019)
Endodontic Treatment (ENVD.UM.CP.0020)
Inhalation of Nitrous Oxide_Oxygen (ENVD.UM.CP.0021)
Interim Caries Arresting Medicament Application (ENVD.UM.CP.0022)
Surgical Extraction (ENVD.UM.CP.0023)
Removal of Residual Tooth Roots (ENVD.UM.CP.0024)
Removable Prosthodontics (ENVD.UM.CP.0025)
Alveoloplasty (CP.DP.33)
Occlusal Guards (ENVD.UM.CP.0034)
Vestibuloplasty (ENVD.UM.CP.0035)
Removable and Fixed Appliance Therapy (ENVD.UM.CP.0036)
Buildups and Posts (CP.DP.39)
Gingivectomy and Gingival Flap Surgery (CP.DP.27)
Osseous Surgery (CP.DP.28)
Full Mouth Debridement (CP.CP.40)
Incision and Drainage (CP.DP.26)
Excision of Soft Tissue (CP.DP.30)
Excision of Bone Tissue (CP.DP.31)
Removal of Foreign Body (CP.DP.32)
Space Maintainer (CP.DP.38)
Frenectomy (Frenulectomy) (CP.DP.41)
Indirect Fixed Prosthodontic Restorations (CP.DP.37 )
Caries Preventive Medicament Application (CP.DP.42)
Required Patient Record Documentation (CP.DP.43)
Orthognathic Surgery (CP.DP.44)