Wiki Oral surgery billing dental implants

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pattihc

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I'm hoping someone on here can help me....

Oral Surgery Billing does not have a lot of information out there.

I am billing dental implants ( 21248/21249/D6010) and depending on the insurance company billed some lines are being denied.

For example, when I bill to Cofinity for 21248 x 1 on four lines of service, I am being reimbursed for 1 line at 100% and the following at 50%.

Medicare on the other hand will only pay for one line of service, no matter the modifier added.

I try to avoid having to bill this code to medical but some cases do warrant medical over dental billing.

Any help is greatly appreciated!!
 
Michelle, this issue came up in my office this past week and the article you provided is perfect for explaining this to our insurance staff person and manager as well as the staff in the Oral Surgery Department and their surgery coordinator! I tried to explain much of this to them but as I took the CPC on 12/20, they are not quite ready to take my word :) Documentation is key! LOL! Thanks so much.
 
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