Hi! I do medical & dental billing for our Texas TMJ office.

One patient I am working with has Humana medical. I called to check benefits & was told the code S8262 needed authorization. I initiated the auth & got a case number. When we filed the claim for the appliance, they denied it, saying there was a coding error. When I called them to get more info, I was told that code is NOT valid and we needed to submit a Medicare-approved code. (Of course the auth dept is separate from benefits/claims, so they didn't tell me it was invalid sooner...)

To my knowledge, Medicare does not cover anything to do with TMJ. We are opted out with them.
Have you had any experience with this? I feel bad for the patient, she was looking forward to her insurance paying something for this, now I am stuck.

Thanks! Catherine