Diagnosis: Impacted tooth
Treatment: Braces and Periodic Treatment Visits
The insurer denied the Braces and Periodic Treatment Visits.
The denial is overturned.

The patient is a male. The request is for orthodontic benefits.

Yes, the Braces and Periodic Treatment Visits are medically necessary.

The patient has an impacted anterior tooth (#11). The tooth is not to be extracted, but rather brought into alignment with orthodontic treatment. This is an automatic qualifier according to the handicapping index scale.