Subject: Tooth positioners for orthodontic treatment
Date: April 30, 2013
Important NoteThis Clinical Policy Bulletin expresses our determination of whether certain services or supplies are medically necessary. We have reached these conclusions based on a review of currently available clinical information including:
A system utilizing aligners may be considered by Aetna as comprehensive orthodontic treatment.
Orthodontic aligners are a treatment modality used for the correction of malpositioned teeth. The total treatment time may vary based on factors such as the difficulty of each individual case and/or system used.
D8070 -- Comprehensive orthodontic treatment of the transitional dentition
D8080 -- Comprehensive orthodontic treatment of the adolescent dentition
D8090 -- Comprehensive orthodontic treatment of the adult dentition
Revision DatesOriginal: November 22, 2005
The above policy is based on the following references:
1American Dental Association. Current dental terminology, CDT 2013: 79.*
2Invisalign website. Align Technology, Inc. March 11, 2011. http://www.invisalign.com
3Joffe L. Invisalign: early experiences. J.Orthod. 2003 Dec; 30:348-52.
4Hajeer MY, Millett DT, Ayoub AF, Siebert JP. Applications of 3D imaging in orthodontics: part II. J. Orthod. 2004 Jun; 31:154-62.
*Copyright 2012 American Dental Association. All rights reserved.
Property of Aetna. All rights reserved. Dental Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical/dental advice. This Dental Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. Participating health care professionals are independent contractors in private practice and are neither employees nor agents of Aetna or its affiliates. Treating health care professionals are solely responsible for medical/dental advice and treatment of members. This Clinical Policy Bulletin may be updated and therefore is subject to change.
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