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Wiki Help with Billing for OMS Services

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rai2004575

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Chapel Hill, NC
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Hey All,

Tried doing a search, but could not find any information providing a solid answer related to my issue.

I need assistance regarding billing for Oral/Maxillofacial surgery services to NYS Medicaid. Medicaid is not paying any of our services (E/Ms or otherwise), stating that the physician performing the service is registered with a Category of Service 0200, which is for "Dentist." They state a physician must be registered with Category of Service 0460 (Professional Services). We attempted to have them registered as such, only to be told, "Providers who are dentists and/or oral surgeons cannot be enrolled under the 0460 physician category because they are not physicians; they went to dental school and as such can only be enrolled under dental specialties."

These are Oral/Maxillofacial surgeons. We are billing Medically necessary medical procedure codes to medical insurance (i.e. 21210, 20670, 20680, 21248, 21249, 21085)

We have them classified with NYS Medicaid with Specialty code 808 for Oral Surgery.

Is there no way around this?

Any assistance is greatly appreciated.
 
Last edited:
rai2004575 said:
Hey All,

Tried doing a search, but could not find any information providing a solid answer related to my issue.

I need assistance regarding billing for Oral/Maxillofacial surgery services to NYS Medicaid. Medicaid is not paying any of our services (E/Ms or otherwise), stating that the physician performing the service is registered with a Category of Service 0200, which is for "Dentist." They state a physician must be registered with Category of Service 0460 (Professional Services). We attempted to have them registered as such, only to be told, "Providers who are dentists and/or oral surgeons cannot be enrolled under the 0460 physician category because they are not physicians; they went to dental school and as such can only be enrolled under dental specialties."

These are Oral/Maxillofacial surgeons. We are billing Medically necessary medical procedure codes to medical insurance (i.e. 21210, 20670, 20680, 21248, 21249, 21085)

We have them classified with NYS Medicaid with Specialty code 808 for Oral Surgery.

Is there no way around this?

Any assistance is greatly appreciated.
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Nothing, huh
 
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