REMINDER ON BONY IMPACTED WISDOM TEETH BENEFIT AND BILLING

Date: 08/01/23

This is a reminder that the removal of bony impacted wisdom teeth is a medical benefit covered by Delaware First Health.  To be eligible for reimbursement, qualified providers (oral surgeons) must bill as follows:

·        Submit claims on the CMS 1500 form with CPT code 41899. Each unit must represent the removal of a bony impacted wisdom teeth.

·        In the comment section of the claim, enter the tooth number and include the specific American Dental Association code for the removal of the impacted tooth.

o   For example: Tooth 1 code D7240 (removal of impacted tooth-completely bony), Tooth 16 code D7230 (removal of impacted tooth—partially bony).

Update:

·        Anesthesia for the removal of bony impacted wisdom teeth should be submitted with CPT code 00170.

IF you have any questions, call Delaware First Health at 1-877-236-1341.