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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.

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