Replacement of Lost or Broken Retainer

Policy No: 54B
Originally Created: 01/01/2001
Section: Orthodontics
Last Reviewed: 01/01/2019
Last Revised: 01/01/2018
Approved: 01/01/2018
Effective: 01/01/2018


Replacement of lost or broken retainer (D8692)


Procedure is in accordance with generally accepted standards of dental practice.

Administrative guidelines

Process to orthodontic benefit.

Not a covered benefit if there is a contract exclusion for lost or stolen appliances.


CDT - D8000-D8999 - see above


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