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#1 Posted : Friday, January 26, 2024 4:35:09 PM(UTC)

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My periodontist just told me I need a gingival graft or else lose some teeth, and then quoted me almost $6000 to do the lower two quadrants of my mouth. They said this figure includes insurance. I called my insurance (DeltaCare USA) to understand this estimate and found out that they simply do not cover the three codes used in my treatment plan. Those codes are:
D7921 x2
D4285 x7
D4265 x2

My question is, is there another insurance carrier who will provide coverage for these codes? And then, a secondary question, are there different codes for extremely similar procedures that either Delta or another insurer might approve? For example, to my admittedly uneducated eye, code D4285 (not covered) looks basically the same as code D4275 (covered). Why is my periodontist using one and not the other when it could so greatly help my financial situation?

Many thanks for any information or insight you can offer.
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