cpt code 40845

jocoffey

Guest
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57
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Hi All,

Our dept. is having problems getting cpt code 40845-complex vestibuloplasty paid, due to payers saying it is not medically necessary, and some payers stating it is a dental code. Can anyone shred any info on this

code or does anyone ever bill this code- Our md's usually perform this on pts' that have had cancer removed from tongue, mouth, and this code is part of the reconstruction after cancer is removed. Any help would

be appreciated. Thanks
 

jackjones62

Expert
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272
Location
Niantic, CT
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We do utilize this code from time to time for removal of oral CA and usually done during a multi-procedural session, I have not seen it denied; unfortunately you have to appeal, just remind those lovely insurance companies that this is a "medical" procedure listed in the CPT book, this is not a CDT, which are the dental procedural codes, therefore it should not be considered "dental"; also, re-enforce that this is part of a larger multi-procedural surgery....

Hope this helps!

Jennifer
ENT
 
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