Hi Jennifer!
It is certainly not uncommon for a medical insurer to prefer the use 41899 in place of a "D" code on the medical claim. While many medical insurer will process D7240 (removal of impacted tooth - completely bony) since there is a not a direct CPT crosscode, not all will.
Tooth numbers can be easily reported on the medical claim using the JP qualifier.
41899 is not necessarily a surgical CPT code, it actually stands for: Unlisted procedure, dentoalveolar structures
Here is some additional information about the JO and JP qualifiers:
The following are the codes for tooth numbers, reported with the JP qualifier:
• 1 –32: Permanent dentition
• 51 –82: Permanent supernumerary dentition
• A –T: Primary dentition
• AS –TS: Primary supernumerary dentition
The following are the codes for areas of the oral cavity, reported with the JO qualifier:
• 00 : Entire oral cavity
• 01 : Maxillary arch
• 02 : Mandibular arch
• 10 : Upper right quadrant
• 20 : Upper left quadrant
• 30 : Lower left quadrant
• 40: Lower right quadrant
Examples of how this would look on the medical claim can be found in the NUCC's CMS 1500 claim form manual here, starting on page 46 & 47:
http://www.nucc.org/images/stories/PDF/1500_claim_form_instruction_manual_2012_02-v5.pdfHope this helps!