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D7285 Biopsy – Delta is saying this code is NOT a separate payable service.

July 14, 2025 by Anonymous

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  • D7285 Biopsy - Delta is saying this code is NOT a separate payable service.

D7285 Biopsy – Delta is saying this code is NOT a separate payable service.

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What can I submit to get Delta PPO to cover this code with out submitting it on a different day of service, tx. Plan: we are extracting wisdom teeth and patient needs Biopsy on LR . this is there reason code :Delta Dental coding update : This is not a separately payable service. Under our guidelines the fee for this procedure is included in the fee for another procedure. For this reason we are unable to pay this charge. Neither the plan nor the enrollee is responsible for payment of tis service.

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Posted by Biller
Asked on July 14, 2025 3:10 pm
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Hi! What extraction code are you billing with the D7285? Sometimes, Delta will bundle D7285 with D7250 and D7210. This denial could potentially be appealed with a detailed narrative written by the provider explaining why the biopsy is necessary and asking that Delta review D7285 under CDT guidelines, because the CDT defines D7285 as a separate diagnostic service.

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Posted by Austinida
Answered on July 15, 2025 6:28 am
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