Orthodontic Billing for Sleep Apnea and TMD

Note on Documentation Requirements:

Establishment of medical necessity of pediatric orthodontics requires documentation to support the severe handicapping malocclusion and the presence of a qualifying medical condition, and a score of 42 points or greater on the Modified Salzmann Index.

Documentation must include a completed Salzmann assessment form and a written report from the attending physician or pediatrician, or qualified medical specialist(s) treating the deformity/anomaly. Progress notes, photographs and other relevant supporting documentation may be included as appropriate.