Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 17,418
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Hello,
We have a patient that has no coverage with either medical or dental for codes 21073 and D7880. In fact, both insurances told us that they do not cover TMD/TMJ whatsoever.
If we bill an E code, they would probably ask for documentation, and said documentation would state that the E code is for treatment of TMD, which would most likely get it rejected.
Are there any codes we could bill the insurance companies to get ANY coverage for our patient?
Thank you for your help in this matter.
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Rank: Administration
Joined: 11/21/2012(UTC)
Posts: 1,611
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Hi Guest!
Great question. Unfortunately, if treatment of TMJ disorder services is completely excluded from the patient's policy, then using different codes will not yield a different result.
It is always a good idea to ask for the insurer for the statement in the policy to verify that it actually is a direct written exclusion on the policy.
Hope this helps!
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