Know the Codes That Dentists Bill For Medical Insurance

See also: How to Find Dental Billing Services in Your Area

Some dental insurance plans cover both primary and extensive dental care and treatments.

However, many people need dental care but lack access and can’t afford to purchase dental insurance; it can be a real struggle to pay the cost of regular teeth cleanings and preventative maintenance.

Many dentists also struggle sometimes to help patients pay bills and maximize their medical insurance. Their usual concern and question is what codes can dentists bill for medical insurance.

According to an analysis from Kaiser Family Foundation, around 37 million people in the U.S. don’t have dental insurance and coverage, and 19 percent of the beneficiaries who seek dental treatment and services have spent over $1,000 coming out of their own pockets.


See also: Does Medical Insurance Pay For Dentures?

While according to the American Dental Association, the top reason people do not plan to visit a dentist is the high cost. Based on the survey, approximately 40.2 percent of adults who didn’t visit a dentist in the past year said they didn’t go because of the cost.

The other 32.7 percent believe that they have excellent oral health, and there’s no need for dental maintenance, and the remaining 14.1 percent tell that they don’t have time to visit a dental clinic due to busyness and their hectic day by day schedule.

For dentists, their number 1 responsibility is to provide a quality dental service to their patients. Oral health is vital to everyone’s general health. Dental care and services are expensive. That is why, in a way, dentists also have the responsibility to help their patients to settle their payments.

Patients need to know that even if you think you have good oral health, it doesn’t mean that there’s no relevant dental problem existing in our oral health. We need to exert extra effort to visit dental clinics and have our oral health checked by a dental professional at least twice a year.

The good news for newcomer dentists and patients in need of dental services is a list of acceptable procedures that some medical insurance will cover.

As a patient whose dental coverage has lapsed or when you’ve reached your dental insurance maximums, and for dentists who want to ensure to maximize insurance coverage for your patients, you can keep this list handy for future references.

The list below aims to answer the common question: What codes can dentists bill for Medical Insurance?

  • E0486 – Sleep apnea appliances
  • D7880 – TMJ appliances and headache treatment
  • 70355– Panorex x-rays
  • 70486, 76376, 76377 – CBCT (cone beam) and tomography
  • 41010, 41115, 41520 – Frenectomy
  • K08.419 – Accidents to teeth
  • 41899 – Third Molar or wisdom teeth extraction
  • K12.31 – Mucositis, and stomatitis (from chemotherapy and other treatments).
  • D6104, D6013 – Dental implants and bone grafts
  • D7285, D7286 – Biopsies
  • 64999 – Botox Injections for bruxism and jaw pain

The heart of dentists’ service is to provide their patients with excellent oral health essential daily and prevent future medical-related problems.

With an excellent opportunity to help patients with medical-related symptoms such as teeth and gum infections, sleep apnea, the temporomandibular joint (TMJ) disorder, or oral surgeries, the dentist needs to know how to maximize medical insurance for their patients.

The ADA is inviting member dentists to take a look and review the CDT Code change. See ADA News for more information.

If you think this article is helpful, check out our free 48-page report to know how you can scale your practice and earn more.

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