2018-12: Reminder: Fluoride Varnish Reimbursable For Children
Date: 02/15/18
As a reminder, per Informational Bulletin 16-7 (IB 16-7) issued on June 27, 2017, by the Louisiana Department of Health (LDH), fluoride varnish applications once every six months for children ages six months through five years is 100 percent reimbursable by Medicaid.
Providers eligible for reimbursement for this service include:
- Physicians
- Nurse practitioners
- Physician assistants
Please Note: The only disciplines that can apply the fluoride varnish are appropriate dental providers, physicians, nurse practitioners, physician assistants, registered nurses, licensed practical nurses and certified medical assistants. Physicians must maintain documentation in the employee records indicating competency for staff involved in the application of fluoride varnish.
How to qualify for this reimbursement:
Eligible provider types must review the “Smiles for Life Caries Risk Assessment, Fluoride Varnish and Counseling Module” and successfully pass the post assessment. The module and post assessment can be found at www.smilesforlifeoralhealth.org.
Fluoride Varnish Application Reimbursement Codes:
- CPT Code: 99188 (Application of topical fluoride varnish) [Note: CPT Code 99188 is only reimbursable when performed on the same date of service as an office visit or preventive screening visit, and should be billed simultaneously with the visit.]
- ICDM-10 Code: Z41.8 (Need for fluoride varnish application)