Dental and Medical Coverage for Procedures Related to Oral Cancer

People may experience different symptoms of a cancerous growth in the mouth, such as reddish or whitish patches, chronic sore throat or hoarseness, or an oral lesion that doesn’t go away. People can check whether they have oral cancer during routine dental or medical exams. If a patient does have oral cancer, depending on the stage of this disease, a patient may see a dental or medical specialist, such as an oral surgeon, radiation oncologist, chemotherapy oncologist, or restorative specialist. Dental and medical insurance can cover procedures related to oral cancer.

Dental insurance and oral cancer

Dental insurance can cover various services related to oral cancer. For example, they may cover oral cancer screenings as a preventive service for 100 percent of the cost. These plans usually cover oral cancer screenings under dental exam codes. Dentists can bill different procedures to dental insurance companies for oral cancer screenings, such as a pre-diagnostic test that helps with the detection of mucosal abnormalities, including premalignant and malignant lesions, incisional biopsies for oral tissues, and brush biopsy for transepithelial sample collection. Dentists need to send a “narrative that describes the reason for necessity and a pathology report for biopsies, exfoliative cytology, and brush biopsies. The biopsies are important because they are the only way to confirm cancer. In these biopsies, dentists get a sample of tissues or cells from the unusual area and send the sample to an oral or medical pathologist depending on the patient’s insurance.

Medical insurance and oral cancer

Medical insurance can also cover procedures related to oral cancer. Dentists can bill some procedures for an oral cancer screening to medical insurance when dental insurance does not cover it. Dentists must show medical insurance that procedures and services, such as biopsies, removal of lesions, or CBCT) are medically necessary for patients. Medical insurance could also cover cancer-related treatment provided by dentists. For instance, medical insurance could cover the removal of teeth before radiation therapy, which may be part of the treatment plan for oral cancer. Patients could also receive dental or medical coverage for procedures provided by specialists, such as oral surgeons, chemotherapy oncologists, etc.

Dental and medical providers deliver different types of services to diagnose oral cancer. If the patient has it, he or she can undergo a treatment plan for his or her condition. Fortunately, the patient can utilize his or her dental and medical insurance for procedures related to oral cancer in order to reduce his or her expenses.

If you are struggling with billing treatment related to oral cancer consider partnering with eAssist. Our Success Consultants are familiar with numerous treatments and will ensure your claims are billed correctly. To learn more schedule a free consultation.

Sandy Odle

Co-Founder and CXO, eAssist

Sandy Odle is the Co-Founder and CXO of eAssist Dental Solutions, where she has played a key role in shaping the company’s business and marketing strategies, leading to record growth and national recognition on the Inc. 500 and Utah Top 100 lists. A passionate social entrepreneur, Sandy believes that business is about building meaningful connections and creating personalized solutions that truly meet customer needs. Her relentless commitment to delivering exceptional client experiences is at the heart of eAssist’s mission. Drawing on the discipline and attention to detail honed during her early career as a ballet dancer, Sandy brings a unique blend of creativity, precision, and work ethic to everything she does.