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This is correct. It is a lot of work for a dentist to go to the OR and this code is the only one that I know of in the CDT code book that describes the preparation necessary to go to the OR. Many times the OR does not have the correct equipment to perform the dental procedure. Whenever I go to the OR, I need to take the equipment necessary for the procedure. It is a lot of work for me and my team.
David S. Peterson DDS
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Dental offices bill the D9420 as a charge for the dentist to do dental work in a hospital setting. There is a lot of work and preparing in order for a dentist to leave his set location to complete work on a patient in a different setting, ie: get pre-cert from the patients medical insurance by typing out a long and detailed narrative along with submitting records, etc., in order for medical insurance to cover the outpatient room and the anesthesiologist. The dentist also cannot see other patients on that day due to not being in the office.
Medical insurances do not cover the code D9420 since it is a dental procedure specifically billed by the dentist. The hospital will charge the medical insurance separately for use of the outpatient room and the anesthesia. Codes are 41899 and 00170.
Hope that helps. Good luck
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The D9420 code is often used when disabled adults or children are treated in hospital setting because they need dental care under sedation.
Often, the medical insurance pays for the medical sedation so it's unclear why on earth the dentist office would be billing for this. They shouldn't.
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Hi Guest,
Yes you can call your Medical insurance and see if you have coverage for the services rendered. You will want to ask your agent what documentation will be needed for you as the patient to file to them. You will most likely need to gather a narrative report explaining what the diagnosis is and what services have been preformed, (the dental office should be able to provide you with the information necessary for you to process your own claim)
Hope this helps!
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I am having this issue right now as my daughter just recently went through oral surgery. I have talked to the billing department at her dentist and they say they cannot bill against our medical insurance. What do I need to do to have this resolved? Do I contact my medical insurance directly and give them the dental code?
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Hi Guest!
Yes it can certainly be billed to your medical insurance. Coverage will depend on your insurer's guidelines and your personal coverage policy.
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I am having the same problem. Can that be billed to my medical?
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Hi guest!
D9420 - hospital or ambulatory surgical center call
Can be cross coded to:
99221 - hospital care, new, level 1
99222 - hospital care, new, level 2
99223 - hospital care, new, level 3
99231 - hospital - subseq., level 1
99232 - hospital - subseq., level 2
99233 - hospital - subseq., level 3
Hope this helps, have a great day!
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What will be the Medical Code for Dental Code D9420 (Hospital Call) as our daughter dentist is not filing for it as they said it will not be covered through Dental Insurance so.
(prsthapit@gmail.com)
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