Another Imagn Billing Success Story:
Imagn Billing Success Story: 3rd Molar Extractions with IV Sedation
| Case Type or brief description: | Extraction D7210/41899, IV Sedation 99152(3), Injection 20550 |
| State and City: | Manchester, NH |
| Insurance Payer: | Harvard Pilgrim Health |
| Total Paid | $728.00 |
Imagn Billing Case Summary
Imagn Billing is a service of Devdent. What follows are the details of another successful Imagn Billing case. You will see how a dental practice in New Hampshire successfully billed for extraction wisdom teeth with IV sedation. The dental practice completed this service 2/1/2021 and submitted to our Imagn Billing team 2/18/2021. The insurer was Harvard Pilgrim Health insurance. The medical claim was paid on 3/2/2021, less than 30 days after it was submitted.
Oral Physician Case Notes
A 22-year-old male patient presented for an evaluation of impaction of 1, 16, 17, 32 with abscess and jaw pain. HPI (history of present illness): patient had increased pain in the posterior maxillary and mandible regions. In addition, he had to have impacted food removed from the areas. The oral physician notes referenced severe inflammation 17, 32 with exudate and bleeding upon probing. Due to the inflammation, poor oral hygiene was evident in the area. Clinical radiographs revealed the start of a mandibular bone cyst.
Proving Medical Necessity
As noted in the providers SOAP note:
- History of recurring pain and inflammation
- Beginning bone cyst
- Impacted wisdom teeth
- Fear of other medical care
Billing Medical Insurance
The dental practice collected all required documentation and clinical SOAP notes. Pre-Authorization was not completed due to service performed prior to submission.
Allowable was $728.00. Total collected from patient and insurance $3154.00. $0.00 applied to deduct, $0.00 applied to co-insurance. Dental insurance paid $2000.00. Patient portion $426.00. Numbers to this Imagn Billing success story are laid out below in the EOB Summary.
| EOB Summary: | |||
| Procedure codes: | Diagnosis codes: | Charges: | Payment: |
| 41899 | K01.0, K01.1 | $2240.00 | $2000.00 |
| 99152(3) | F40.232 | $728.00 | $728.00 |
| 20550 | K01.0 | $186.00 | $ 0.00 |
The medical insurance paid 100% of the IV sedation fee and the dental insurance applied benefits for removing the teeth. This patient’s parents were ecstatic that the provider obtained an additional $728.00 in medical benefits that would have had to come out of their pocket. The dental practice enjoyed becoming another Imagn Billing success story from Devdent. Dentrix customers, learn how about becoming your own Imagn Billing success story here.
