(b) Surgical extractions--includes local anesthesia and routine post-operative care:
(c) Other surgical procedures:
NOTE 2: Excision of fistulous tract between maxillary sinus and oral cavity and closure by advancement flap.
(d) Alveoloplasty surgical preparation of ridge for dentures:
1. Reimbursement will be based upon quadrants.
NOTE 2: Specify quadrant.
(f) Surgical excision of reactive inflammatory lesions (scar tissue or localized congenital lesions):
NOTE: Biopsy report must be available upon request for review by the Division's dental consultants.
1. Includes lesions of skin, subcutaneous or mucous membranes, pyogenic granulomata and opercula.
1. In the excision and management of this type of lesion, a biopsy report must be available for review by the Medicaid/NJ FamilyCare dental consultants.