Still battling with insurance and provider.

So a bit ago I posted this https://www.reddit.com/r/HealthInsurance/comments/vojog6/medical_and_dental_insurance_coding/?utm_source=share&utm_medium=ios_app&utm_name=iossmf and I’m still just stuck.

My IN NETWORK oral surgeon through my medical insurance’s office still refuses to give me a stupid K01.1 diagnosis code for my wisdom teeth removal that are impacted. They gave me the procedure codes, but they “don’t deal with medical” so they won’t give me a diagnosis code, so they won’t bill my medical insurance even though it will cover it 100%.

I’ve called insurance so many times, some people are helpful others are not at all. They’ve asked me just to submit a reimbursement which I can’t do because that requires a diagnosis code, which I can’t get. They’ve told me to use a different provider but I can’t because all of the providers I can go to work for the same office (I have very restrictive employer health insurance where I can only go to one hospital system). They’ve told me to file an out of network waver to go somewhere else but when I tried it got shut down because there technically is someone in my network who can do it.

Am I just SOL and need to pay out of pocket for this or is there like someone at my insurance company who I should ask to talk to? I have dental insurance but it only covers 50% up to a max, so I’d really prefer to have this done at 100% covered. The oral surgeons office has called my insurance but all they asked was if I have dental coverage which obviously I don’t since they called my medical insurance 🙄🙄.

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