Dental Preauthorization

Preauthorization Requirements Effective January 1, 2026

To ensure medical necessity and prevent service duplication, PA is required for certain procedures. Our new system is programmed to automatically detect and verify PA requirements during claim processing. Claims for these procedures without PA will be denied. Please update your processes and notify staff to ensure compliance.

This list shows dental codes that require preauthorization.

Note: We will no longer accept unspecified CDT codes (e.g., D9999) on submitted claims. All procedures must be reported using the most specific and appropriate CDT code available. Claims submitted with unspecified codes may be denied or delayed pending resubmission with proper coding.

Questions? Contact us via the Message Center in the New Provider Portal or call us at 801-366-7542.