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2thlaserSpectator@d2thdr 55188 wrote:
I’m grasping at straws to help this woman, and on the way through the discussion, began to wonder if anyone has tried to extract teeth on a patient with a long history of IV bisphosphonate therapy using the laser as a means to not traumatize the bone?
Am I daffy wondering about this? There are 3 teeth that would be removed, 2 molars and a bicuspid….all mandibular.
Thanks
Murph,
Great questions. I think the laser Er:YAG would be a great choice in using a small 200-300 micron tip to trough around the PDL, and gently loosen up the tooth, like a periotome. I have done this routinely and it works great. Next I follow with the Nd:YAG and clot the blood and biostim the site for 2 min after the procedure, and there is extremely fast healing and virtually zero pain afterwards…just my experiences….Good luck, let us know what you decide to to!
Mark
2thlaserSpectatorWes,
Ron Kaminer is in NYC…he is reputable…with the laser.
Mark
zendentistSpectator@2thlaser 58274 wrote:
Wes,
Ron Kaminer is in NYC…he is reputable…with the laser.
MarkThanks, Mark, will pass that on.
zendentistSpectator[YOUTUBE]http://www.youtube.com/watch?v=h3YppuHgxsY[/YOUTUBE]
and, since the YouTube Icon doesn’t seem to be working, here’s the direct link code:
Michael AielloSpectatorYes. Delta doesn’t recognize use of the PerioLase during D4240, so its treated the same as D4250.
Either way you have to prove to them what technique and devices were used. For coverage it has to be traditional scalpel and flap + sutures. Otherwise you should be able to get alternative benefits such as SRP and occlusal adjust.
Michael AielloSpectatorRon,
For Delta patients I try to keep it simple. They are told that their insurance covers a portion of what we do during LANAP. We estimate what full mouth SRP coverage is and tell the patients that this dollar amount is what we estimate the insurance will cover.
Internally we take our LANAP Fee and subtract the SRP benefit. E.g. LANAP $4,000 – 4 Quads SRP $1,000 = $3,000 Pt portion
We don’t bother with guessing if splinting, occlusal adjustment, or other billable treatments would be covered. After LANAP we will bill Delta for these “alternative benefits” to help the patient out. This way the patient is grateful if they get additional money back.
If you are allowed, it is easier to bill directly to regular Delta (vs. Focused Review) for these covered benefits without bothering to submit for payment of D4260/D4240 through focused review.
For rejected LANAP we used to bill Delta for SRP, occlusal adjustment, or any other legitimate procedure performed without going through the focused review address. Then Delta changed its policy and flagged the billings that were denied D4240/D4260 and sent these claims to focused review.
In my situation Delta wanted us to send in LANAP by using code D4260/D4240 with our charged fee and include D4999 with LANAP fee less SRP fee. To me, this gets confusing. That’s why, if you are allowed, skip focused review since LANAP won’t be paid for anyway and bill regular Delta for those procedures that may be covered.
We don’t hide the fact that insurance coverage may be higher for scalpel osseous surgery but we also stress it is up to the patient to weigh the pros and cons of each treatment. For patients with low insurance maximums it is not as punitive as those with higher.
The bottom line is that Delta will pay for SRP and typically occlusal adjustment. The rest is out of pocket.
John LeitnerSpectatorIn the future, I hope to post ‘samples’ of letters I’m having my Delta patients write to their insurance company. I have two patients who went through the treatment before Delta’s decision that are writing letters now. I’m giving them pre and post (one year) treatment probings to hand out with the letter to Delta. The company won’t listen to us, but MAYBE they will listen to the ones paying their bills. It’s a small way to fight this postion, but an important one. I would encourage you to have pre-decision patients write to Delta giving them their views on the procedure and results, or maybe even current patients wanting to go ahead. More later as I can – – -, John
JanetCenturySpectatorThanks for posting. That was really smooth.
sagoodellSpectatorHey guys,
I just got off the phone with Tom McClelland.
Our situation is that we are finding it necessary to become participating providers again, but we need to get this issue surrounding LANAP figured out first. I have approached Delta from the perspective of an office manager who is just looking for guidance so that we can move forward and change our participating status. I played dumb.
It has taken more than a month and I have been shuffled around lke crazy, but today, out of the blue, Tom McClelland called me. I have the conversation on tape.
Here is the scoop: he told me that we can bill S/RP, the appliance, the occlusal adjustment and the perio exams and put the “laser part of the procedure” in a D4999 code. They will deny that “until such time as they are satisfied with the science” and we CAN bill it to the patient.
Dr. McClelland told me that if I have any problems with this to call him directly through his assistant, Jason.
Just thought I would let you all know.
Sam
2thlaserSpectatorThe New Lares/Fotona Powerlase AT, Lightwalker Series Er:YAG/Nd:YAG lasers are here! If you have been kicking around wondering when to buy a hard/soft tissue laser, I think you might want to check this out. Here’s some stuff from the lares website: http://www.laresdental.com/lightwalker_laser_1.asp
There has been a lot of chatter online lately by Glenn how laser dentistry is in for a change, and well, here you go.
There will be three different models. One with just an Er:YAG for hard/soft tissue, it will sell for $29.995.Another with an Er:YAG/Nd:YAG combo, it will sell for $39,995.00.
And finally the Full featured model which is Er:YAG/Nd:YAG-with 2 fiber sizes, and all the bells and whistles like the Powerlase AT Spa model. $49,995.00.
As a person who trains many dentists on lasers, these are breakthrough prices that should interest those who have been kicking the tires so to speak. I am going to invite Brian or Dick to tell you more when they can.
Again, you can get more from their website listed above.
State of the art LightWalker™ Features
Smaller, Sleeker, Lighter
The LightWalker lasers are small and sleek enough to easily fit and maneuver within your operatory. Lighter weight means easier movement.
Fast, Efficient Cutting
No other lasers cut as fast as LightWalker lasers for hard or soft tissue, period.
Simple Treatment Selection
The LightWalker color screen offers a simple “paint by the numbers” menu of pre-programmed laser treatments. You pick the treatment, and the laser automatically sets your optimum starting parameters.
Unmatched Patient Comfort
Lightwalker lasers are so gentle for cavity preparations and most soft tissue procedures that patients rarely require anesthetic.
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November 3, 2010 at 10:05 pm in reply to: Lares/Fotona New Lightwalker Er:YAG/Nd:YAG digital pulsed lasers…. #24092
teddySpectatorMark,
I’ve been reading about the PIPS endo…and watched the video from the WCMID meeting. It looks just fascinating. How long have you been doing this procedure? Are they working out well? Seems to me that just doing one or 2 root canal treatments a month (I refer them all out) would pay for the laser.November 4, 2010 at 4:52 am in reply to: Lares/Fotona New Lightwalker Er:YAG/Nd:YAG digital pulsed lasers…. #24089
dkimmelSpectatorAs much as I am excited to see the drop in Er prices ,
That fact that Mark is now referred to as a SENIOR has me ROFLMAO.
We just need to see his advatar changed with a picture
Of him reading the latest AARP!!! 🙂November 6, 2010 at 7:19 pm in reply to: Lares/Fotona New Lightwalker Er:YAG/Nd:YAG digital pulsed lasers…. #24093
2thlaserSpectator@dkimmel 58328 wrote:
As much as I am excited to see the drop in Er prices ,
That fact that Mark is now referred to as a SENIOR has me ROFLMAO.
We just need to see his advatar changed with a picture
Of him reading the latest AARP!!! 🙂Funny, very funny!
November 6, 2010 at 7:21 pm in reply to: Lares/Fotona New Lightwalker Er:YAG/Nd:YAG digital pulsed lasers…. #24094
2thlaserSpectator@teddy 58327 wrote:
Mark,
I’ve been reading about the PIPS endo…and watched the video from the WCMID meeting. It looks just fascinating. How long have you been doing this procedure? Are they working out well? Seems to me that just doing one or 2 root canal treatments a month (I refer them all out) would pay for the laser.We have been doing PIPS for over four years now. There will be a ton of research being published in the next couple of months. Very exciting times, and yes, it would definitely pay for your laser in many ways…..Thanks Teddy!
Mark
AnonymousInactiveI heard a rumor that AMD will have a new Erbium and will undercut the market like they did with the diode.
Is this true?
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