Filling out a medical claim for wisdom teeth extractions

Your CPT code is the D7220 and D 7230. (The extraction is the procedure) You won’t have a modifier. Your diagnosis code will come from a ICD 10 code book. This is the why it’s being pulled. Are they impacted,, etc that’s the code you would put . If you tell me why it’s being extracted I can send you a code.

I recommend billing CDT codes to the patient's medical pollen. Use form CMS 1500.

Before submitting the claim to the patients medical insurance, call their medical insurance to ask if they provide out of network coverage and coverage for impacted wisdom teeth extractions. If they say no to either, you can skip submitting the claim to medical. Instead if they say they do not provide out of network coverage, resubmit to dental with the note, “The patients medical policy does not provide out of network coverage. Please see preop radiographs for claim processing.” If the medical insurance state they do not cover impacted extractions, resubmit to dental with the verbiage, “The patients medical plan does not cover impacted teeth extraction. See preop radiographs for payment consideration.” This will usually override their request for medical EOB and get the claim paid.

However, if it is a covered code with medical, the diagnosis code would be K01.1.