Oral & Maxillofacial Surgery Billing

Yes. All coding is performed by certified coders, and specialty assignment is deliberate rather than incidental — dual coding across CDT and CPT, where the same procedure has a dental code and a medical code with different coverage.

Three causes account for most of it: procedure billed to dental when medical covers it; medical necessity narrative not attached; anesthesia billed without supporting documentation. Each is a documentation or process failure rather than a coverage dispute, which is why we report denials grouped by cause instead of as a single rate.

Medical plans cover what is medically necessary while dental plans cover the rest, and cross-over billing between them is the whole job. That shapes which denials are worth appealing and where the front-end effort should sit, so it drives how we staff the work rather than being background color.

No. Payment is decided by the payer, and any firm promising a collection rate is describing something it does not control. We commit to the process and to six reported numbers you can check against your own system.

Codes are assigned from the documentation the practice provides, and where the record does not support a code we raise a query rather than infer intent. The clinical record and the certification of medical necessity remain the practice's, and claims go out under the provider's own National Provider Identifier.