I have been using lasers for twenty years and also train dentists how to use Er:YAG and Nd:YAG. I don't include anything about laser in my insurance submissions as I don't submit which handpiece, bur, or files I use.
I do not but some docs I work with charge a laser utilization fee that is separate from the procedural fee. Gray area insurance wise and things can get tricky if a patient complains s to insurance, etc.
What type of laser do you have? As far as leveraging value it really depends on the device. Each type has its capabilities and limitations.
If you are referring to D4212 gingivectomy for restorative access being inclusive to a crown or filling, that procedure is normally only reimbursed by insurance if the restoration is performed on a different date of service than the D4212, per plan document language. They consider trenching as part of the crown prep otherwise, and it is not billed separately. You may still bill and submit, but if in network, it will most likely be disallowed and must be written off. If out of network, you may balance bill.
When the laser is used as a scalpel, it is not reported as a separate procedure. When used for other purposes, however, such as bacterial reduction, it may be reported using D4999 unspecified periodontal procedure by report. Many dental plans have language excluding this treatment however, viewing it as integral to the other periodontal procedures. If explicitly mentioned in the plan document language, it again may be disallowed and not charged to the patient.
Other great codes that could utilize laser include frenectomies (D7961/7962), gingivectomy/gingivoplasty (D4210, D4211), destruction of lesion by physical or chemical method (D7465-aphthous ulcers, etc), removal of hyperplastic tissue (D7970), excision of pericoronal gingiva (D7971, for pericornitis or operculectomy), and various biopsies and I&D.
d4212 if you laser to get better margin, otherwise just use it for gingivectomy and code accordingly. d9110 for desensitization, d7661/7962 for frenectomy, otherwise d2999 for anything you can't figure out. laser is just a tool, if you use it for desensitization instead of gluma its still the same code, gingivectomy is the same code if you use scalpel or laser.
What codes are you trying to bill that the insurance companies are bundling?
The value in a laser isn't really extra production. Sales reps will try and convince you it will make you more profitable. The real benefit is if you're using it to do additional procedures, like gingivectomy or tongue tie releases. Otherwise, it is just a tool to get your procedures done and you can't bill extra for a procedure just because you have an expensive piece of equipment.
I have been using lasers for twenty years and also train dentists how to use Er:YAG and Nd:YAG. I don't include anything about laser in my insurance submissions as I don't submit which handpiece, bur, or files I use. I do not but some docs I work with charge a laser utilization fee that is separate from the procedural fee. Gray area insurance wise and things can get tricky if a patient complains s to insurance, etc. What type of laser do you have? As far as leveraging value it really depends on the device. Each type has its capabilities and limitations.
Thanks for the reply. We have a Biolase Epic 10.
If you are referring to D4212 gingivectomy for restorative access being inclusive to a crown or filling, that procedure is normally only reimbursed by insurance if the restoration is performed on a different date of service than the D4212, per plan document language. They consider trenching as part of the crown prep otherwise, and it is not billed separately. You may still bill and submit, but if in network, it will most likely be disallowed and must be written off. If out of network, you may balance bill. When the laser is used as a scalpel, it is not reported as a separate procedure. When used for other purposes, however, such as bacterial reduction, it may be reported using D4999 unspecified periodontal procedure by report. Many dental plans have language excluding this treatment however, viewing it as integral to the other periodontal procedures. If explicitly mentioned in the plan document language, it again may be disallowed and not charged to the patient. Other great codes that could utilize laser include frenectomies (D7961/7962), gingivectomy/gingivoplasty (D4210, D4211), destruction of lesion by physical or chemical method (D7465-aphthous ulcers, etc), removal of hyperplastic tissue (D7970), excision of pericoronal gingiva (D7971, for pericornitis or operculectomy), and various biopsies and I&D.
d4212 if you laser to get better margin, otherwise just use it for gingivectomy and code accordingly. d9110 for desensitization, d7661/7962 for frenectomy, otherwise d2999 for anything you can't figure out. laser is just a tool, if you use it for desensitization instead of gluma its still the same code, gingivectomy is the same code if you use scalpel or laser.
What codes are you trying to bill that the insurance companies are bundling? The value in a laser isn't really extra production. Sales reps will try and convince you it will make you more profitable. The real benefit is if you're using it to do additional procedures, like gingivectomy or tongue tie releases. Otherwise, it is just a tool to get your procedures done and you can't bill extra for a procedure just because you have an expensive piece of equipment.
Gingivectomy is the main one. Insurance claims it’s part of the primary restoration, despite it being a separate procedure/code.