Delta Dental NJ: infected root canal requires jaw bone graph not covered. $9400?!
My partner (28M) has an infected existing root canal (tooth 19) that has caused an infection in the jaw bone. His endodontist is recommending a bone graph, implant, and crown. Insurance is not covering anything. Would this not be considered medically necessary as he is at risk for bone loss due to infection? How can we get this covered?
His plan only offers one in-network endodontist in the entire state of NJ. We have gotten 2nd and 3rd options from out of network providers who had similar opinions and quotes. He has also gotten a round of antibiotics to help reduce the infection.
(D6060) ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (PREDOMINANTLY BASE METAL) $ 2,022
(D6057) CUSTOM FABRICATED ABUTMENT – INCLUDES PLACEMENT $ 1,532
(D6010) SURGICAL PLACEMENT OF IMPLANT BODY: ENDOSTEAL IMPLANT $ 2,541
(D7950) OSSEOUS, OSTEOPERIOSTEAL, OR CARTILAGE GRAFT OF MANDIBLE OR MAXILLA, BY REPORT $ 3,299
submitted by /u/TurbinesGoWoosh
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