Pre-Authorisation Requirements

The following are required for crown and bridge pre-authorisations:

• An x-ray clearly showing the entire clinical crown, the neck and the upper part of the alveolar bone; typically a peri-apical for anterior teeth
• The tooth number in FDI format ( i.e. two-digit numbering)
• The major clinical code to be used: e.g. 8409 (crown – porcelain/ceramic); 8411 (crown – porcelain with metal). If a post is envisaged, please tell us the primary code for the post and/or core
• A detailed laboratory quote
• In the case of a bridge, information about any further planned treatments is required along with the above information. For example, this could be a short description about what is planned for other missing or damaged teeth

Note: Further clinical information may be requested to support an authorisation request.

Email: crowns@denis.co.za
Fax: 0866 770 336
Post:   Private Bag X1, Century City, 7446

The following are required for orthodontic pre-authorisations:

• A cephalometric analysis
• An orthodontic treatment plan
• A panoramic x-ray
• Pre-treatment photographs showing the bite in occlusion: the front view, left-side view and right-side view
• Pre-treatment photographs showing a full occlusal view of the mandibula and the maxilla
• A cephalometric x-ray

  Note:

• Please submit clear copies of documents and radiographs to ensure authorisation requests are processed as fast as possible.
• Further clinical information may be requested to support an authorisation request.

Email: ortho@denis.co.za
Fax:    0866 770 336
Post:   Private Bag X1, Century City, 7446

The following are required for periodontic pre-authorisations:

• A full periodontic chart of CPI-scoring
• A full treatment plan
• X-rays
• A detailed maintenance plan for the remainder of the benefit year

  Note:

• Please submit clear copies of documents and radiographs to ensure authorisation requests are processed as fast as possible.
• Further clinical information may be requested to support an authorisation request.
   

Email: perio@denis.co.za
Fax: 0866 770 336
Post: Private Bag X1, Century City, 7446

The following are required for in-hospital pre-authorisations:

• Hospital practice number
• Anaesthetist practice number
• Treating clinician
• Hospital admission date
• Procedure code(s) with ICD-10 code(s) and where relevant the applicable tooth numbers
• If applicable, medical report of special medical conditions
• A medical report to clinically substantiate a medical condition that warrants General Anaesthetics​
• Clear X-rays of the impacted teeth are requiredNote:

• Please note that all hospital cases are assessed individually.
• Further clinical information may be requested to support an authorisation request.

Email: hospitalenq@denis.co.za

Post: Private Bag X1, Century City, 7446

The following are required for conscious sedation pre-authorisations:

• Anaesthetist practice number
• Treating clinician
• Proposed treatment date
• Procedure code(s) with ICD-10 code(s) and where relevant the applicable tooth numbers
• If applicable, medical report of special medical conditions
• Clear X-rays of the impacted teeth are requiredNote:

• Please note that all sedation cases are assessed individually.
• Further clinical information may be requested to support an authorisation request.
   

Email: hospitalenq@denis.co.za

Post: Private Bag X1, Century City, 7446

The following are required for plastic and partial metal frame denture pre-authorisations:

• For partial dentures, the missing tooth numbers
• For full dentures, an indication of the applicable jaw

Tel : 0861 033 647
Email: customercare@denis.co.za
Fax:        0866 770 336
Post: Private Bag X1, Century City, 7446