tci Medicare Compliance & Reimbursement - 2006 Issue 17

DENTAL SERVICES: 2 Practices Succeed In Overturning 'Routine' Dental Denials

Medicare will cover dental services when they're medically related.Providers aren't taking denials of "routine" services as the last word. Two practices found ways to appeal those denials and obtain their rightful reimbursement.Medicare never pays for "routine" services such as dental care. But Medicare will pay for dental services that are an integral part of a covered procedure, such as a jaw reconstruction after an accident. Medicare will also pay for oral examinations preceding kidney transplant or heart valve replacement, according to the Centers for Medicare & Medicaid Services Web site.Two practices succeeded in turning a denial...

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