Question: I have filed a claim with Delta Dental for an impacted wisdom tooth and they denied it because they want myself, the dentist, to file a claim with medical first. I have never filed a medical claim and I am not what necessary steps need to be taken. Please help!
QUESTION: I have filed a claim with Delta Dental for an impacted wisdom tooth and they denied it because they want myself, the dentist, to file a claim with medical first. I have never filed a medical claim and I am not what necessary steps need to be taken. Please help!
ANSWER:
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To begin:
1. Reach out to the patient and ask them for their medical insurance card.
2. Call the medical insurance and ask if they will pay for the treatment that has been completed (ie: wisdom tooth extraction)? Do you need a pre-authorization? Make sure to keep detailed information on who you spoke to, date and time, phone numbers, along with claim information.
3. If YES, ask if you can bill them on a dental claim form and ask for a fax to send it to someone directly. Keep a confirmation page that it was sent.
4. If they say NO, ask the best way to get a denial to use for the dental plan.
To find codes:
Sample of a diagnosis code:
- K01.1Â is the ICD Diagnosis code
- Since there is no specific CPT code for reporting the removal of impacted teeth, simply report the appropriate dental code in box 24D of the CMS-1500 medical claim form. If the carrier does not accept HCPCS codes, then report CPT 41899 and include a brief narrative describing the procedure performed.
Proprietary. *Information from ICD10data website[/mepr-active]