Wiki Billing Tooth extractions-Medical

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Good afternoon. I have two oral surgeons who are billing tooth extractions for medical reasons. In some instances, they are removing multiple teeth. We are using the unlisted code, 41899 x # of teeth removed. For example, if the patient is having 4 teeth removed, we are billing 41899 at 4 units.

MC is denying our claims for the # of units. Does anyone have any suggestions on the best way to bill these claims? Bill each on a separate line?

Any help would be greatly appreciated.

Thanks,

Jamie
 
When using unlisted codes, a single code represents the entire procedure, so you would not bill multiple units. Payers price unlisted codes based on a review of the operative report, so there is no advantage gained by submitting 4 units instead of 1 unit in this situation. It is recommended when using unlisted codes that you suggest a comparable code that the payers can use - in this case you may wish to suggest 4 times the rate of a single extraction, for example, since that would be what is supported by your documentation. But you the use of additional units of the unlisted code itself is not correct and likely to cause rejections, as you've already noted. Hope this helps some.
 
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Tooth extractions

Good afternoon. I have two oral surgeons who are billing tooth extractions for medical reasons. In some instances, they are removing multiple teeth. We are using the unlisted code, 41899 x # of teeth removed. For example, if the patient is having 4 teeth removed, we are billing 41899 at 4 units.

MC is denying our claims for the # of units. Does anyone have any suggestions on the best way to bill these claims? Bill each on a separate line?

Any help would be greatly appreciated.

Thanks,

Jamie

Have you considered submitting CDT codes instead of CPT codes? They cover multiple extractions.
 
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