Hello,

We've been billing Medicare for excision of infected bone with bone graft to repair the defected areas for a couple years and have never had a problem with reimbursement. We understand Medicare has many restrictions when it comes to oral surgery, which we are confident we're meeting medical necessity. However, lately we've been receiving automatic denials for cpt codes: 21215, 21210, 21025, and 21026. Per the eob: Claim/service lacks information or has submission billing errors which is needed for adjudication.

However when I call Medicare they state that codes are automatically being denied for medical review. Is anyone else experiencing this issue with Medicare? Any information/feedback is greatly appreciated.

Thank you,

Rosie
Accu-Dental & orthodontics