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Pre-Determination Procedure
Reminder: Pre-Determinations are no longer required for the following services:
  • Preventative
  • Diagnosis
  • Restorative Fillings
  • Emergency Treatment
  • Patients who present a specific symptomatic problem and/or dental emergency such as trauma or acute infection

Procedure codes affected include: D0120, D0140, D0150, D0210, D0330, D1110, D1120, D1206, D1208, D1351, D2140, D2150, D2160, D2330, D2331, D2332, D2335, D2391, D2392, D2393

Electronic Pre-Determination

For services requiring pre-determination, submit electronically (Payer ID: ARGUS) (NEA: 451001). Include appropriate member information, clinical findings and radiographic support. Please allow 14-days for review and processing.

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