The American Dental Association and American Association of Oral and Maxillofacial Surgeons requested to meet with CMS regarding recent denials of oral pathology claims in a Sept. 17 letter.
The organizations said there have been frequent denial of procedures involving the removal of samples from the mouth or jaws, despite them being covered by CMS.
They said the denials may stem from a chapter of the Medicare benefit policy manual that states "Items and services in connection with the care, treatment, filling, removal or replacement of teeth, or structures directly supporting the teeth, are not covered."
But the dental associations said biopsies and sample collections are not a form of dental treatment.
"We believe that there is a distinction between dental care and a diagnosis as a step that precedes the care of patients with oral lesions," said ADA President Daniel Klemmedson, DDS, MD, and B.D. Tiner, DDS, MD, president of the American Association of Oral and Maxillofacial Surgeons, in the letter.