Diagnosis: Dental Problems/ anterior crossbite.
Treatment: Orthodontic treatment/visits.

The insurer denied Comprehensive orthodontic treatment of the adolescent dentition and periodic orthodontic treatment visit x 12.
The health plan's determination is overturned.

The patient in question is a female with an anterior crossbite on teeth 7 and 10. She presents with a skeletal Class I malocclusion with moderate crowding in the maxilla and mandible. She is treatment planned for 24-30 months of orthodontics to address the crowding and crossbite.

Comprehensive orthodontic treatment of the adolescent dentition and periodic orthodontic treatment visit x 12 are medically necessary for this patient.
This patient presents with an anterior crossbite on teeth 7 and 10, as well as significant crowding. Side effects of an untreated anterior crossbite include abnormal wear to the affected teeth and labial displacement of the mandibular incisors that can lead to periodontal defects. If left untreated the damage that will likely occur to the patient's teeth will be much more time consuming and difficult to correct than the patient's existing orthodontic problem. For this reason, treatment is deemed medically necessary.