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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.

February 14, 2012 by Admin

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  • 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.

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.

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Posted by Admin
Asked on February 14, 2012 7:49 am
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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.

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Answered on February 15, 2012 7:49 am
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