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DPAP 217

Bone Graft Billing Guidelines


Provider Administrative Policy

Section
General Billing
Policy Date
January 2014
Status/Date
New/January 2014
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Blue Cross of Idaho works diligently on behalf of our members to develop contracting relationships with Idaho dental providers and Blue Cross Blue Shield dental affiliates (national Dental Grid).

 


Policy

Bone Graft Billing Guidelines

The Code of Dental Procedures and Nomenclature (CDT Code) is published by the American Dental Association (ADA). Please refer to the CDT code for proper coding of your claims for the services provided.

Bone Graft Placement:

The CDT code may include a bone graft code per tooth, per site, or per each additional site for the surgery or defect type. The CDT code will generally specify the procedures to be included in each CDT code. Please refer to the CDT descriptor for proper coding.

Barrier Membrane:

Barrier membranes may be separately billable and are specific to the surgery or defect type. Please refer to the CDT descriptor for proper coding.

Biologic Materials:

Biologic materials used to aid in tissue regeneration may be separately billable and should be reported using their own unique codes. Please refer to the CDT descriptor for proper coding.

Bone graft billing is not to be bundled under a single bone graft code. Bill in accordance with the current CDT coding guidelines. Improperly coded claims may be returned to your office.


Policy History

Date Action Reason