Maxillofacial Surgeons
A number of years ago, Centers for Medicare and Medicaid Services (CMS), which was then known as HCFA, did not recognize any distinction between true maxillofacial surgeons and non-specialized dentists. Thus, both true maxillofacial surgeons and general dentists were enrolled under the same provider type: #19. Compounding the confusion, the official name for specialty #19 still is "Oral Surgeon."
Since then, maxillofacial surgeons have been recognized by CMS as being a separate specialty from general dentistry. Thus, most maxillofacial surgeons are now enrolled as specialty #85, rather than specialty #19. Unfortunately, there are a number of maxillofacial surgeons that are still enrolled in Medicare as specialty #19. This is causing problems for them regarding their submitted claims. Many surgical procedures are being denied to these surgeons because they are not the type of services that a general dentist would perform. These maxillofacial surgeons will eventually get paid by Medicare, but their payments are being delayed.
WPS strongly suggests that all maxillofacial surgeons who are not currently enrolled as specialty 85 contact Provider Enrollment to correct this error. If not, they will continue to have claims delayed or even denied.
