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#1 Posted : Tuesday, September 3, 2024 9:54:24 AM(UTC)
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I have two questions. 1) a site I was on indicated that for complete bony extractions used K01.0 and for partial or surgical extraction of a wisdom tooth to use K01.1 (which I don't see how you'd used that for a surgical extraction anyway but that's what it said). My OS said there's really no difference in the embedded vs impacted and to just keep billing K01.1 as we've not had any issues. IS there a difference in those diagnoses?
2) UHC sent out notification that as of Feb 1,2025 they will require GA modifier for commercial plans to charge members for non-covered services and that written consent must be obtained prior to service being done. Is this something we should do for ALL commercial plans moving forward? Nine times out of 10 I'm strictly billing medical because dental requires an EOB not because it's a covered benefit. Are there modifiers that should be applied to the extractions as well if it's a known non-covered service?
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