what is the difference between dental codes D4266 and D7956

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what is the difference between dental codes D4266 and D7956

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I was charged code D4266 by my dentist and my insurance changed it to code D7956 and they covered it. I had to pay out my pocket for code D4266. Should I ask for a refund for the D4266 charge?

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Asked on August 14, 2023
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D4266 is Guided Tissue Regeneration – Resorbable Barrier, Per Site, typically used in areas where natural teeth still exists. —Sometimes placed over area of root surface following a periodontal surgery to enhance healing. D7956 Guided tissue regeneration, edentulous area - resorbable barrier, per site, is the code likely to be used in areas of an edentulous space/missing tooth. Sometimes recommended by your dentist for bone regeneration in the area of missing tooth, where the provider is prepping for an implant. If your dental office utilized the incorrect code, insurance may deny that the code used is for natural teeth only and the tooth was already extracted. If your insurance had reprocess the claim with the correct code D7956 and paid, your dentist should receive that payment and refund you the difference after deductible and coinsurance balance have been paid. You can contact your dentist’s office and let them know you had spoken with your insurance and they have corrected the treatment code and paid.
(Anonymous at August 16, 2023)
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    Yes if insurance changed code and pd of course you ask for money back.

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    Answered on August 14, 2023
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    Private answer

    i would call your insurance co and ask them for an explanation and then contact the provider to ask about the refund policy they may have issued a credit to your account this is common practice. both codes pertain to Tissue regeneration but each have their own specific set of rules for when they can be used, they may have just billed the wrong code initially.

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    Answered on August 14, 2023
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