My Cancer Doctor stated that the health insurance should pay for Oral reconstruction due to CPT Diagnosis of Medullary Thyriod Carsonoma. Also, the treatment for the condition is Iodine 131 radiation which was for neck and head. The Oral surgeon submitted the claims for the procedures with D-codes and used Diagnosis codes (CPT Codess) that were medical in nature.

K08134
Z85.85
Z92.3
Z98.811

Together with procedure codes:
D7210
D6104
D6011
D4266
D7950
D7921

Since I have both health and Dental Ins with the same carrier and use the same ID #, th understanding was that it would go to the Health portion 1st because of the CPT codes and then the remaining would funnel thru Dental. When the PD was submitted, we were informed that the CPT Diagnosis was irrelivent if the procedure ICD-10 codes were Dental. There would need to be coresponding ICD-10 codes that were not D- codes but the 5 digit corresponding ICD-10 medical codes.

So, I am at a loss, since the procedures are, in fact, dental, but the reason is for a health issue, I'm not really sure what the difference that would make. If the CPT codes were for a trauma, ie car accident, or for Bulemia or a fall. Cancer, Oral in nature treated by high radiation, is supposed to be considered reason for the case to pay thru Health 1st, where was the error in the PD? Were there differing ICD-10 procedure codes that correspond to the dental procedures that will be performed - with different results?

Please Help!!??!