My dental insurance plan does not cover osseous graft (code D42634) when done in conjunction with an apicoectomy (code D3410). The retrograde filling (D3430) was allowed. It seems to me the osseous graft was medically necessary, so I am trying to understand the logic of disallowing it when done in conjunction with the surgery. The insurance company customer service representative was no help... all she could do is read the statement in the guidelines, but she could not explain the reason behind the guideline. My dentist just says it was a medically necessary procedure and can't explain why my insurance company has that restriction.
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MAYBE THEY CONSIDER THIS OVERTREATMNT FOR THIS 1 TOOTH.
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