Reminder: FEP Dental Claims for Oral Surgery

As a reminder, dental providers submitting medical CPT codes for oral surgery may not be reimbursed as if they had billed ADA D-Codes.

Dental providers may file claims using medical CPT codes or ADA D-Codes; however, CPT codes have different pricing than ADA D-codes. It is recommended that providers expecting to be reimbursed for ADA D-Codes file claims using ADA D-Codes, or there may be a delay in processing.

Additional information can be found in the Provider Blue Book, Section 19.2: Code Sets and Identifiers.  Providers can also contact their provider services representative for guidance.

This applies to Federal Employee Program (FEP).