We understand that we can bill dental insurance for PPE, but can we bill medical insurance instead?  The answer is yes, you can bill PPE to medical insurance, but before we move on to the medical code, I’ll tackle dental coding first.

Dental Code for PPE

The American Dental Association (ADA) recently issued guidance for dentists billing for PPE. The ADA has also provided a list of insurers that provide reimbursement (from $7 to $20) for PPE using code Current Dental Terminology (CDT) code “D1999 – unspecified preventive procedure, by report”. You can find the ADA guidance in the Statement on Third Party Payer Reimbursement for Costs Associated with Increased Standards for Personal Protective Equipment (PPE) here.

Now that we know the dental codes, how does our dental office bill PPE to medical insurance?

We recently received this question from a client:

“We bill medical insurance for sleep apnea appliances, TMJ splints, and oral surgeries such as bone grafts, frenectomies, and dental implants. Can we bill for additional PPE we are using during the COVID era to medical insurance too?”

The answer is yes, you can bill PPE to medical insurance. A code for supplies and materials can be submitted to medical insurers for PPE.  Typically, two pairs of non-sterile gloves are already included for every evaluation and management (E/M) service billed to medical, such as 99202 for a new patient exam. For supplies used over and above the norm, the Current Procedural Terminology (CPT) code and description is listed below:

CPT Code 99070; Supplies and materials, except spectacles, provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided).

Be sure to include a description of the supplies on the CMS 1500 claim form. To indicate the nature of the supplies, include the words, Personal Protection Equipment in the “supplemental information” field on the claim form above the supply code.

As always, when billing medical for services performed in a dental office, a SOAP report of medical necessity outlines subjective complaints, objective exam findings, the dentist’s assessment (with ICD-10 codes listed) and the plan. SOAP narrative reports can be generated in DentalWriter Software to serve as documentation of medical necessity for services, including supplies.

Learn More About Medical Billing

Another superb solution for further instruction is Nierman CE+, an online medical billing course for dentists and their team who wish to successfully navigate medical billing. Nierman CE+  is a new, online learning platform with courses that thoroughly teach the billing of supplies, accidents, emergency care, TMJ disorder, sleep apnea appliances, and oral surgeries to medical insurance.