Obstructed Canal?

[Lori48]

I am having a root canal done through a bridge. My insurance company pays for the root canal. However, the dentist added endodontic obstructed canal for an additional charge I am responsible for. Does going through the bridge make it "obstructed?" How would he know its obstructed until he starts the work? I just want to make sure it's a legit charge. Thanks in advance for any advice!

 

[Brause]

Obstruction​

In an ideal world, each canal that needs to be cleaned is completely unobstructed. In the real world, though, there are often obstructions that affect a canal that contains infected material and makes cleaning more difficult. Examples of obstructions that can impinge on a canal are another tooth, a filling, etc. When an obstruction is present, the dentist will do their very best to clean every portion of the canal around that obstruction. In such cases, though, some infection material can persist. In such cases, that root canal might fail.

Source: https://www.eastchestermeredental.c...tructions that can,that root canal might fail.

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Sometimes the full length of the root canal system may be inaccessible owing to an obstruction. This may be due to:

• a retained instrument (Fig 7-1)
• blockage of natural tooth substance or foreign material
• a ledge created iatrogenically.

Source: https://pocketdentistry.com/7-managing-canal-obstructions/

 

[Little Hawk]

I had the same question which is "How would the endodontist know the root canal is obstructed (in my case, it's calcified,) until he starts the work?"
You didn't answer that question and I'd like to know because this is what I was told when I went for the consultation for a root canal procedure. I had x-rays including a 3-D x-ray and was told that my dental insurance won't cover obstruction removal and i have to pay over $300 out of pocket for that. I googled to find out why insurance companies won't pay for it and the answer was that insurance companies suspect "upbilling" for obstruction removal, which makes it *sound like* endodontists often are charging for an unnecessary procedure. (lying about the presence of an obstruction to get more money, fraudulently.
So I guess my specific question would have to be:
Can calcified root canals be seen in x-rays taken a the time of root canal consult, prior to any actual procedure being done?
Second question is, If the calcification is VISIBLE and the x-rays are sent to the company with the pre-authorization, and it's obviously present and removal of it is necessary in order to do the root canal procedure, why wouldn't the insurance companies pay for it?

 

[MattKW]

An standard xray will usually show how calcified (obstructed) a canal is likely to be; a CBCT (3D) will be more precise.
Any tooth that has previously been crowned is likely to be calcified because the repeated damage to the tooth from large fillings and then a crown will speed up calcification, plus age of patient.
Health insurers will not assess the X-rays you send them; they not dentists. Unfortunately, some Item Codes are inappropriately used by naughty dentists which stuffs up the system for the honest ones. This sort of abuse has been going for ages and insurers can see trends from their billing data.