Released 3/4/26
An eligibility response can now contain information about the following:
- For a given code, any codes that have the same frequency limitation as that code. For example, a D2710 (resin-based crown) may have the same frequency limitation as a D2712 (3/4-resin-based crown).
- For a given code, any alternate benefit code and the reason for the alternate benefit. For example, a D2710 (resin-based crown) may downgrade to a D2719 because a downgrade applies for codes in the standard crown group.
If this information is in the response, when you view the response (in an HTML format), you will notice a Shared Freq/Alt Benefit column with the information.
