Fallon Health · PayerPolicy · FALLON-MEDICAL-POLICY-ORTHOGNATHIC090125
Summary of the payer’s published policy. Not a coverage determination — confirm with Fallon Health before submitting.
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Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.
Backwork has no codes on record for this policy. Check the source.