WSR 97-16-105

INTERPRETIVE OR POLICY STATEMENT

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES

[Filed August 6, 1997, 9:25 a.m.]

Document Title: Numbered Memorandum #97-55 (MAA).

Subject: Replacement of GAU/W specific procedure codes with American Dental Association (ADA) procedure codes.

Effective Date: September 1, 1997.

Document Description: Effective for claims with dates of service on or after September 1, 1997, the selected dental procedures covered by MAA for GAU and W program clients are to be billed using the comparable ADA procedure codes. Refer to the complete procedure code description in the Dental Program Billing Instructions, dated August 1995. This memorandum lists these specific codes.

To receive a copy of the interpretive or policy statement, contact Anne DeJarnette, Administrative Regulations Analyst, Department of Social and Health Services, Medical Assistance Administration, Division of Program Support, P.O. Box 45530, Olympia, WA 98504, phone (360) 664-2320, TDD 1-800-848-5429, FAX (360) 753-7315, e-mail dejarae@dshs.wa.gov.

Roxie Schalliol, PASS