- Dental Services
- Dental Services
- Enrolling in Medicare
- Medicare Coverage Exclusion: Dental Services
- Claim Submission Guidelines
- Medical Documentation Requirements
- New Medicare Provider
- Additional Development Request Letters Guide
- Medicare Coverage Exclusion: Dental Services
- Inpatient Services in Connection With Dental Procedures
- The Utilization of the KX Modifier on Dental Claims
- Modifier GY
- Standard Companion Guide Health Care Claim: Dental (837D)
- 837D Edit Spreadsheet
- Dental Claim Cross Over
- Attention Clearinghouses and Vendors!
- Resources
Inpatient Services in Connection With Dental Procedures
When a patient is an inpatient of a hospital for a dental procedure and the dentist's service is covered under Part B, the inpatient hospital services furnished are covered under Part A. For example, both the professional services of the dentist and the inpatient hospital expenses are covered when the dentist reduces a jaw fracture of an inpatient.
When the hospital services are covered, all ancillary services such as X-rays, administration of anesthesia, use of the operating room, etc., are covered.
Even if the inpatient hospital services are covered, the medical services of physicians furnished in connection with non-covered dental services are not covered.
Note: Anesthesiologists, radiologists, or pathologists whose services are performed in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting teeth are also not covered.
Reviewed 6/26/2024