u/fuckedbyanxiety

Pre-Treatment Estimate vs EOB Codes

I got my wisdom teeth out a couple weeks ago and received my EOB. While looking it over there is about a $600 difference from my pre-treatment estimate to my EOB and after talking to my insurance it is because on my pre-treatment they marked the extractions as D7210 but on the post-treatment EOB they marked it as D7140 so my sedation was denied as it was seen as not necessary for the 7140 (80% coverage on the pre-treatment estimate). Had I known it would have been denied for the removal type, I wouldn’t have gotten the sedation. If my provider doesn’t change the code to reflect the 7210, is there anything I can do to get the sedation covered or am I just SOL?

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u/fuckedbyanxiety — 12 hours ago

Surgeon billed differently than estimate

I recently got my wisdom teeth out and at the consultation they did an estimate that included iv sedation. They did the billing code as a surgical removal on the estimate which would have allowed the iv sedation to be covered but on the actual EOB they billed it as simple removal which caused the iv sedation to be denied. This feels dumb but I wouldnt have done the sedation if I knew it wouldnt have been covered. Is there anything I can do?

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u/fuckedbyanxiety — 14 hours ago