What is an occlusal appliance?
An occlusal appliance is a detachable device, usually manufactured of hard acrylic, that fits over the occlusal and incisal surfaces of one arch’s teeth, allowing precise occlusal contact with the teeth of the opposing arch. It’s also recognized as an occlusal splint, bite guard, night guard, interocclusal appliance, or orthotic.
Uses Of Occlusal Appliances
These appliances can be used for various purposes; some of them are as follows.
- These appliances temporarily introduce a stable occlusal condition that can significantly change neuromuscular reflex operation, improving certain muscle pain disorders.
- Occlusal appliances can also generate an occlusal environment that allows the condyles to assume their most orthopedically stable joint position.
- They are also used to shield teeth and support structures from abnormal forces that could cause breakdown or tooth wear.
- Occlusal guards can protect your teeth from a variety of conditions. It aids in the relief of bruxism’s uncomfortable and sometimes painful symptoms.
Importance of Dental insurance verification services
It can assist practices in determining whether the patient’s insurance plan covers occlusal guards. That is necessary for the practice to be reimbursed.
Nightguards/ occlusal appliances are classified into three types.
- Hard night guards may be fabricated with an added soft liner that covers all of the teeth on the upper or lower jaw,
- Soft night guards are pliable that cover all of the teeth on the upper or lower jaw.
- Hybrid nightguards are hard on the outside but softer on the inside and cover all teeth on either the upper or lower jaw.
Does medical insurance cover occlusal guards?
While most dental insurance plans cover preventative care like cleanings and x-rays, not all plans cover primary care like crowns and night guards. Coverage for occlusal guards under a patient’s medical strategy varies considerably. However, a range may be available if the patient’s condition being treated meets the plan’s medical necessities. Some dental plans will only cover bruxism if it is diagnosed. Provide a narrative with your diagnosis explaining why an occlusal guard is needed and what situation is being handled. Verifying coverage before beginning treatment can significantly reduce claim denials.
Approaching the correct guard code on dental insurance claims ensures that the claim is handled correctly and effectively. The report removed the code D9940 (occlusal guard) by the report (Removable dental appliances designed to reduce the effects of bruxism and other occlusal factors) in the 2019 CDT coding update.
Latest CDT codes for occlusal guards
The following are the latest CDT codes for documenting occlusal guards.
D9942 Restoration and relining Occlusal guard
D9943 Modifying the occlusal guard
Occlusal guard D9944 – hard appliance, an entire arch
Occlusal guard D9945 – soft appliance, a full arch
Occlusal guard D9946 – hard appliance, partial arch
Removable dental appliances are intended to reduce the effects of bruxism and other occlusal factors. D9944, D9945, and D9946 codes should not be reported for sleep apnea, snoring, or TMD appliances. The American Dental Association recommends that full or partial arch guards with any hard occlusal component, regardless of whether or not they have a soft component, be programmed as hard guards – either D9944 for an entire arch appliance or D9946 for a partial arch appliance.
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