I submitted a predetermination and was given a denial due to 273/FNG. It states the frequency limitation has been exceeded, but I have never had the partial done. How is that possible?
I apologize for the confusion caused by the denial.
I did confirm your statement regarding the frequency limitation based on your history.
With that, as your enrollment recently beginning, the service would still be denied. To cover initial placement of a bridge, or partial or complete denture, the functioning tooth or teeth will not be covered until after the covered person has been covered under the plan for 12 consecutive months.
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