General anesthetic and teeth extraction

[cathypatten]

I am in the process of getting dentures and my insurance covers everything but the general anesthetic because they dont see it as medical necessity,I am appealing their decision and my argument is going to be that general anesthetic is a necessity,how else could a oral surgeon remove teeth that are broke off at the gum line?Unless there is something I am missing here,or am I wrong here?

 

[Zuri Barniv]

It is not medically necessary to get any kind of sedation for oral surgery, but in some cases it can make it a lot nicer for you. With local anesthetics alone (shots in your mouth), you should not feel anything the surgeon is doing except for the sensation of pressure. By the way, you probably don't mean "general anesthesia" which is usually done in a hospital by an anesthesiologist and a machine breathes for you. Most likely you are referring to "IV sedation" which is done in the dentist's office, you are semi-conscious but mostly asleep and, the big thing, is you breathe on your own without the help of a machine. BIG difference between the two terms. Unless you are getting something exceptional done in your mouth (and it doesn't sound like you are), the insurance is very unlikely to pay for IV sedation if your policy doesn't cover it.

 

[cathypatten]

Thank you for your reply,and ya think your right,looking at my papers and it says general anesthesia but below it it explains given through a vein and total loss of consciousness.Anyways guess I assumed being put out was absolutely necessary because thats what the surgeon said needed to be done,so is it possible to ask the surgeon to just give me local?(and hopefully it will be covered,or at least a little cheaper if I do have to pay it)

 

[Zuri Barniv]

Hmmm....well, I just want to emphasize that IV Conscious Sedation is very different than general anesthesia. Your papers should say "IV Sedation", "Conscious sedation" or something like that. You are technically conscious when you get this, unlike general anesthesia where you are unconscious. There is also a HUGE difference in cost between the two as well. I would clarify exactly what this office is planning to do. And if they were planning to, indeed, do general anesthesia, that would be way overkill for some tooth extractions.