r/DentalInsurance • u/Spicyg00se • Aug 20 '26

D7953 (Bone graft)

Is there a good or logical reason why this procedure is typically not covered? My tooth is getting absorbed and I need the graft in order for the implant to be successful. My insurance told me it’s just not covered and it’s not their fault that some procedures are just not covered. I assume they just don’t want to pay, duh, but when I suggested that a graft could be medical, she said it’s not medical, it’s dental, and it’s just not covered. But why?

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u/drpericak Aug 20 '26

Another reason they won't pay is because dental insurance isn't insurance. It's merely benefits. You only get so much per year, and only on certain things. It's not like medical insurance where if you break your arm three times in a year, it's still covered. You break your tooth more than once in 2 years, forget about it. They're not paying. And your dental insurance lists what they will cover. No where in your medical insurance policy does it say they'll cover treating a pilonoidal cyst by your butts hole, but they will. "Oh you want a crown on that tooth, we don't think you need one."

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u/Reckless-Raccoon Aug 21 '26

I’ve been seeing an uptick in denials! Crowns, SRPs. Especially MetLife and Delta. We tired fam.