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Navigating Dental Coding with Kyle: Advanced Insights on Occlusal Guards

• D9944 Occlusal Guard–Rigid Appliance, Full Arch

• D9945 Occlusal Guard–Flexible Appliance

• D9946 Occlusal Guard–Rigid Appliance, Partial Arch

Justification for Dental Coverage:

• Some dental plans offer coverage for patients grappling with bruxism-related issues.

• Specific plans may consider coverage for an occlusal guard if the patient has undergone recent periodontal treatments like scaling and root planing, along with osseous surgery within the last six months.

Potential Reasons for Insurance Rejection:

• Neglecting to utilize the updated 2019 CDT codes provided above.

• Failing to specify the reason for fabricating the appliance on the ADA claim form.

• Reaching the annual maximum benefit limit.

• Coverage eligibility is subject to frequency and constraints, underscoring the importance of confirming the patient's occlusal guard appliance history.

Always ensure timely submission of a pretreatment authorization, inclusive of radiographs and periodontal charting, to expedite the claim evaluation process.

Don’t forget to join our vibrant community of dental office managers, where support, collaboration, and growth thrive. With over 15,000 like-minded professionals, our Facebook Community is a hub for knowledge, inspiration, and camaraderie. Together, we empower each other to navigate the dynamic landscape of dental office management, share the best practices, and elevate our collective expertise. Join us in shaping the future of dental office management and unlocking the possibilities for success! 

Author bio- With over 22 years of experience in the dental field, Kyle L. Summerford has honed a unique approach to case presentation and patient acceptance. As a seasoned dental office manager and financial dental consultant, he leverages his expert knowledge to assist both new and struggling dental practices. Through his education programs, Mr. Summerford empowers staff members with effective patient education skills and persuasion techniques, significantly enhancing overall case acceptance rates. 

Driven by a passion for teaching and sharing knowledge within the dental community, Mr. Summerford has lectured at numerous Continuing Education (CE) events and prestigious academic institutions, including Stony Brook University, the New York City County Dental Society, and Georgia Regents University. His expertise is further recognized through his self-authored articles in his renowned dental coding column, "Dental Coding with Kyle." 

Mr. Summerford is also the founder of the Dental Office Managers Community and These platforms serve as invaluable resources for dental professionals, fostering connections and facilitating the exchange of knowledge among peers.


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