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Can an oral surgeon bill D Codes to a payer without having a dental contract.
Denial stated not a covered procedure for D6010
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Hi Guest!
Great question. Did you mean medical insurance, or dental? (our forte here is medical insurance for dental practices).
Yes, some medical insurers will accept the "D" codes on a medical claim when there is not a direct cross code available for it.
D6010 - surgical placement of implant body: endosteal implant
can be cross coded to:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial(3 or less)
21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more)
Of course, if the patient only has in-network benefits available (i.e. many HMO plans) - you may run into an issue there, so be sure to do a thorough benefit verification first.
Also keep in mind, not all medical policies will offer coverage for all implants. They do need to be deemed medically necessary, and not cosmetic in nature.
Hope this helps!
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Rank: Guest
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