Wiki Dental Procedures in ER

[Nancy Grisanti]

Our emergency room providers would like to provide fx tooth splinting, reduction of tooth avulsions and temporary tooth fillings. How would I find the codes for these procedures or should they be incorporated into the e/m code? Can these procedures be billed by ER providers or do they have to be billed by a dentist? Any feedback would be very helpful.

 

[philipwells]

Every time we bill for ER services when the only DX is dental caries or anything dental related it gets denied as "Dental services are non-covered when performed in emergency room setting"

May want to check with specific payers but I'm afraid it's not going to be reimbursed to an ER physician.

The insurance's reasoning is they should have went to the dentist. = (

 

[thomas7331]

It's been a while since I was involved in that end of things, but it used to be that injuries to healthy teeth were covered under medical plans but anything else related to teeth was covered only by the dental plans. The dental codes will usually get denied by the medical plans, so if it is a legitimately medical service, the way to go is probably with unlisted codes, though I'd expect an argument before you'll see payment on those.