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Agmt98 Delta Dental
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Agmt98 Delta Dental
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Last modified
7/5/2005 2:59:37 PM
Creation date
5/20/2005 2:45:37 PM
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Agreement
Contractor Name
Delta Dental
PROJECT NAME
coverage for police officers & sergeants
RMP File Number
304
Date
2/2/1998
Reso Ref
13279
Box
5933
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<br />-- <br /> <br />---- <br /> <br />----- <br /> <br />Removal of tumors, cysts and neoplasms <br /> <br />07430 <br />07431 <br /> <br />07440 <br /> <br />07441 <br /> <br />07450 <br /> <br />07451 <br /> <br />07460 <br /> <br />07461 <br /> <br />07465 <br /> <br />Excision of benign tumor -- lesion diameter up to 1.25 cm <br />Excision of benign tumor -- lesion diameter greater than <br />1. 25 cm <br />Excision of malignant tumor - - lesion diameter up to <br />1.25, by report <br />Excision of malignant tumor -- lesion diameter greater <br />than 1.25 em, by report <br />Removal of odontogenic cyst or tumor -- lesion diameter <br />up to 1.25 cm <br />Removal of odontogenic cyst or tumor -- lesion diameter <br />greater than 1.25 em <br />Removal of nonodontogenic cyst or tumor <br />diameter up to 1.25 cm <br />Removal of nonodontogenic cyst or tumor <br />diameter greater than 1.25 cm <br />Destruction of lesion(s} by physical methods, by report <br /> <br />lesion <br /> <br />lesion <br /> <br />Excision of bone tissue <br /> <br />07470 <br />07480 <br />07490 <br /> <br />Removal of exostosis -- maxilla or mandible <br />Partial ostectomy (guttering or saucerization), by report <br />Radical resection of mandible with bone graft, by report <br /> <br />Surgical incision <br /> <br />07510 <br />07520 <br />07530 <br /> <br />07540 <br />07550 <br />07560 <br /> <br />---- <br /> <br />intraoral soft tissue <br />extraoral soft tissue <br />subcutaneous areolar <br /> <br />Incision and drainage of abscess -- <br />Incision and drainage of abscess -- <br />Removal of foreign body, skin or <br />tissue <br />Removal of foreign bodies -- musculoskeletal system <br />Sequestrectomy for osteomyelitis <br />Maxillary sinusotomy for removal of tooth fragment or <br />foreign body <br /> <br />10 <br /> <br />---- <br /> <br />u_- ------- <br /> <br />----------- ---- <br />
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