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202003-126657

2020

Fidelis Care New York

Medicaid

Dental Problems

Dental/ Orthodontic Procedure

Medical necessity

Overturned

Case Summary

Diagnosis: Crossbite.
Treatment: Braces and monthly visits.
The insurer denied Braces and monthly visits. The denial is overturned.

The patient is a teen-aged female. Tooth #7 is in crossbite with tooth #26 on the bottom. This will cause trauma to both of them over time, with resulting fracturing and/or loosening of either tooth. Orthodontic treatment and monthly follow up appointments are needed to correct the severe crowding this patient has and allow these teeth to be in proper alignment. This will correct the crossbite and help prevent broken and loose teeth in the future.

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