1. A-P CORRECTION OF GREATER THAN 2mm
2. AUTOROTATION OF THE MANDIBLE REQUIRED FOR VERTICAL/ A-P CORRECTION
3. CR-CO DISCREPANCY CORRECTION/TREATMENT TO OTHER THAN CENTRIC OCCLUSION
4. SEVERE DEEP BITE OPENED TO IDEAL OR OPEN BITE TO BE CLOSED TO IDEAL
5. EXTRUSION OF TEETH GREATER THAN 1mm, UNLESS IT IS PART OF TORQUING OR IN CONJUNCTION WITH INTRUDING ADJACENT TEETH
6. SEVERLY TIPPED TEETH (>45 DEGREES)
7. MULTIPLE MISSING TEETH, EXISTING DECAY, OR POOR RESTORATIONS
8. SHORT CLINICAL CROWNS (<70% OF NORMAL SIZE)
9. POSTERIOR OPEN BITE
10. MOVEMENT OF THE ENTIRE ARCH REQUIRED FOR A-P CORRECTION (WHOLE ARCH DISTALIZATION OR MESIALIZATION)

1. PREMOLARS, CANINES, OR MOLAR EXTRACTION CASES
2. IMPACTED TEETH/FORCED ERUPTION
3. SKELETAL EXPANSION
4. SURGICAL CASES

1. MIXED DENTITION CASES
2. ERUPTING PERMANENT DENTITION
3. UNTREATED CARIES, FRACTURED CROWNS/FILLINGS, OR UNTREATED PERIODONTAL DISEASE.
4. TMJ SYMPTOMS/PATHOLOGY
5. CASES WITH DISTAL EXTENSION PARTIAL DENTURE
6. SINGLE-ARCH TREATMENT CASES WHERE OPPOSING ARCH IS BEING TREATED CONCURRENTLY WITH FIXED APPLIANCES

1. CORRECTION OF TOOTH SIZE DISCREPANCY WILL BE VIA:
2. INTERPROXIMAL REDUCTION OF LOWER INCISORS TO CREATE OVERJET TO RETRACT UPPERS.
3. LEAVE SPACE DISTAL TO THE MAXILLARY LATERAL INCISORS

OUR OFFICE ALSO ACCEPTS MEDICAID, AND IN ORDER FOR OUR OFFICE TO RECEIVE NORTH CAROLINA MEDICAID ORTHODONTIC APPROVAL THE PATIENT'S CASE MUST MEET CERTAIN CRITERIA.  THE PROBABILITY FOR APPROVAL WILL BE INCREASED WHEN TWO OR MORE OF THE FOLLOWING CRITERIA EXIST:

CRITERIA FOR FUNCTIONALLY HANDICAPPING CONDITIONS:

• SEVERE SKELETAL CONDITION (RECIPIENT'S AGE AND THE DIRECTION OF GROWTH ARE ALSO CONSIDERED)
• OCCLUSION (SEVERE ANTERIOR/POSTERIOR, TRANSVERSE, AND VERTICAL DISCREPANCIES, CROSSBITES WITH FUNCTIONAL SHIFTS)
• CROWDING MUST BE MODERATE TO SEVERE AND FUNCTIONALLY INTOLERABLE OVER A LONG PERIOD OF TIME (E.G., OCCLUSAL DISHARMONY AND/OR GINGIVAL STRIPPING SECONDARY TO SEVERE CROWDING)
• OVERBITE MUST BE DEEP, COMPLETE, AND TRAUMATIC
• OVERJET (EXCESSIVE PROTRUSTION 6+MM)
• OPENBITE (EXCESSIVE 4-5MM)
• PSYCHOLOGICAL AND EMOTIONAL FACTORS (E.G., PSYCHO-SOCIAL INHIBITION TO THE NORMAL PURSUITS OF LIFE)
• POTENTIAL THAT ALL PROBLEMS WILL WORSEN

NONCOVERED TREATMENT (THE FOLLOWING TYPE CASES ARE NOT ELIGIBLE FOR APPROVAL):

• EARLY TREATMENT CASES IN THE MIXED DENTITION
• MINOR TOOTH MOVEMENT CASES REQUIRING A RELATIVELY SHORT TREATMENT PERIOD (I.E., LESS THAN TWELVE MONTHS)
• CUSPID IMPACTIONS WITH A POOR PROGNOSIS OF BEING BROUGHT DOWN INTO OCCLUSION IN THE PRESENCE OF NO OTHER SIGNIFICANT PROBLEMS
• BILATERAL OR UNILATERAL POSTERIOR CROSSBITES OF MODERATE SEVERITY WITHOUT A SIGNIFICANT MANDIBULAR SHIFT OR HISTORY OF TEMPOROMANDIBULAR DYSFUNCTION AND A LACK OF OTHER SIGNIFICANT PROBLEMS
• CLASS I MALOCCLUSIONS WITH MODERATE CROWDING, NO CROSSBITES, OVERBITE AND OVERJET WITHIN NORMAL LIMITS
• SIMPLE SPACE CLOSURE OF MILD TO MODERATE ANTERIOR SPACING
• SIMPLE ONE ARCH TREATMENT
• LOCALIZED TOOTH ALIGNMENT PROBLEMS REQUIRING A RELATIVELY SHORT PERIOD OF TREATMENT(E.G., SIMPLE ANTERIOR OR POSTERIOR CROSSBITES, DIASTEMA CLOSURE, ROTATIONS, ETC.)

INTERCEPTIVE ORTHODONTICS IS STILL CURRENTLY NOT COVERED BY NORTH CAROLINA MEDICAID.  ALL FUNCTIONAL TREATMENTS INVOLVING FIXED OR REMOVABLE APPLIANCES (E.G., ARCH EXPANDERS, RETAINERS, ETC.) ARE ALSO NOT COVERED.  IF THE CASE IS MEDICAID APPROVED FOR FIXED TREAMTENT, THE RECIPIENT SHOULD NOT BE BILLED FOR FUNCTIONAL TREATMENT OR APPLIANCES NECESSARY TO COMPLETE MEDICAID APPROVED TREATMENT.  ANY TREATMENT RENDERED AFTER MEDICAID APPROVAL SHOULD BE REIMBURSED ONLY BY MEDICAID UNLESS THE RECIPIENT IS COVERED BY THIRD PARY DENTAL INSURANCE.