I have a patient coming into the office who needs a 3 unit bridge replaced. The patient has medicare insurance. I know medicare does not pay for dental work but the patient has had cancer of the mouth and has lost his upper palate to cancer. The patient wears a Definitive obturator. The 3 unit brigde helps hold his obturator in. Well medicare pay for this and what ICD-9 code do I use. Thank You.
Most likely Medicare will not cover this procedure, you may contact Medicare and see if they will pre-authorize the procedure based on the systemic disease (cancer) and the need for a prosthesis to return normal functionality of chewing.
