If you’ve ever had a surgical claim denied and couldn’t figure out why—this one’s for you. Medical cross coding is one of the trickiest parts of oral surgery billing, and unfortunately, it’s also one of the most expensive when done wrong.
Here are three common mistakes we see every week that cost practices time, money, and trust.
- Using the Wrong Code Set Dental codes (CDT) don’t always apply to surgical cases. If the claim should go to medical first, CPT® codes are often required—and using the wrong one almost guarantees a denial. You also need the correct modifiers, diagnosis codes, and place-of-service. Every detail matters.
- Missing or Weak Documentation Even when the codes are correct, missing or incomplete documentation can tank your claim. That means clinical notes, imaging, referrals, and a clear explanation of medical necessity. If the insurance reviewer can’t find a reason to pay, they won’t.
- Not Knowing When to Bill Medical First Some procedures must be billed to medical before dental. Many practices get caught in the cycle of billing dental first, getting denied, and then restarting the entire process. That delay can mean months of lost revenue and frustrated patients.
How to Avoid These Mistakes This isn’t something most in-house billing teams are trained for. That’s why working with a team that understands surgical billing—and medical cross coding specifically—makes all the difference.
At Insurance Billing Experts, we’ve been handling complex OMFS claims for years. We know the code sets, documentation requirements, and payer quirks. And as part of the DNTEL community, we have access to real-time insights from other billing leaders.
If you’re spending too much time chasing down unpaid surgical claims, we’re here to help get it right the first time.