N.M. Stat. § 13-7-9
General anesthesia and hospitalization for dental surgery.
A. Group health care coverage, including any form of self-insurance, offered, issued
or renewed under the Health Care Purchasing Act shall provide coverage for
hospitalization and general anesthesia provided in a hospital or ambulatory surgical
center for dental surgery for the following:
(1)
insureds exhibiting physical, intellectual or medically compromising
conditions for which dental treatment under local anesthesia, with or without additional
adjunctive techniques and modalities, cannot be expected to provide a successful result
and for which dental treatment under general anesthesia can be expected to produce
superior results;
(2)
insureds for whom local anesthesia is ineffective because of acute
infection, anatomic variation or allergy;
(3)
insured children or adolescents who are extremely uncooperative, fearful,
anxious or uncommunicative with dental needs of such magnitude that treatment should
not be postponed or deferred and for whom lack of treatment can be expected to result
in dental or oral pain or infection, loss of teeth or other increased oral or dental
morbidity;
(4)
insureds with extensive oral-facial or dental trauma for which treatment
under local anesthesia would be ineffective or compromised; or
(5)
other procedures for which hospitalization or general anesthesia in a
hospital or ambulatory surgical center is medically necessary.
B. The provisions of this section do not apply to short-term travel, accident-only or
limited or specified disease policies.
C. Coverage for dental surgery may be subject to copayments, deductibles and
coinsurance subject to network and prior authorization requirements consistent with
those imposed on other benefits under the same group health care coverage, including
any form of self-insurance.