CommercialAdministrativeMedium impact
04.00.05d, Extraction of Bony Impacted Teeth and Exposure of Impacted Teeth
Independence Blue Cross·Oral & Maxillofacial Surgery, Dentistry·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
The policy for extraction of bony impacted teeth and exposure of impacted teeth has been reissued with an effective date of April 1, 2026. This appears to be a routine policy reissuance maintaining existing coverage guidelines for these dental surgical procedures.
Action Required
By March 31, 2026: Review current billing practices for bony impacted tooth extractions and impacted tooth exposure procedures. Verify that existing authorization and documentation requirements remain compliant with the reissued policy. No immediate changes required as this appears to be a routine reissuance.