Monday, December 17, 2012

Medicare does cover these types of dental services


Dental services that are an integral part of a covered procedure (e.g., reconstruction of the jaw following accidental injury).

Extractions done in preparation for radiation treatment for neoplastic diseases involving the jaw.

                                                   Oral examinations, but not treatment, preceding kidney transplantation or heart valve replacement, under certain circumstances. Such examination would be covered under Part A if performed by a dentist on the hospital's staff or under Part B if performed by a physician. This is because the purpose of the examination is not for the care of the teeth or structures directly supporting the teeth. Rather, the examination is for the identification, prior to a complex surgical procedure, of existing medical problems where the increased possibility of infection would not only reduce the chances for successful surgery but would also expose the patient to additional risks in undergoing such surgery.

Hospital stays if needed for emergency or complicated dental procedures, even when the dental care itself is not covered. In these cases you should call your Part A contractor for more information.

Inpatient hospital services in connection with the provision of such dental services if the individual, because of his underlying medical condition and clinical status or because of the severity of the dental procedure, requires hospitalization in connection with the provision of such services.

Surgical procedures for the reconstruction of a ridge as the result of and at the same time as a tumor removal (for other than dental purposes).


Dental splints are covered if used in conjunction with the treatment of a covered medical condition (i.e., dislocated upper and/or lower joints).

Medicare makes payment for a covered dental procedure no matter where the service is performed. The hospitalization or non-hospitalization of a patient has no direct bearing on the coverage or exclusion of a given dental procedure.

Payment may also be made for services and supplies furnished incident to covered dental services. For example, the services and supplies of a dental technician or nurse who is under the direct supervision of the dentist or physician are covered if the services are included in the dentist's or physician's bill.

Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.



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