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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Goldenhar Syndrome A Medical Condition?

i was born with golden hars syndrome which causes bad teeth and have had to deal with abcessed teeth for years now.im currently on medication to fight off another LR Abcess on the jaw.I have 5 teeth left to get orally cut out.Is this considered a medical condition since i have had this issue since a child?? Im on penicillian VK and was on amox 850 before that.The company i work for refuses to consider this a "medical condition"
Mon, 30 Jun 2014
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Dentist,  's  Response
Hello,
I understand your frustration. Use the words "medical necessity" when discussing your dental treatment.
You must treat your abscesses in your mouth coming from your teeth. You have dental problems as a result of a medical problem. Your medical coverage probably excludes dental treatment except for certain surgeries. Try consulting with an oral surgeon or root canal specialist, an endodontist, to see if there are some codes that overlap between dental and medical conditions that can be utilized. In some instances, a refusal of coverage under a dental code allows submission to medical coverage.
Keep open your discussion. Do not give up. This is a difficult area to address and they may stand on an exclusion clause, but I encourage you to continue to address with your documented medical condition.
Thank you for your inquiry. I hope you are successful.
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Is Goldenhar Syndrome A Medical Condition?

Hello, I understand your frustration. Use the words medical necessity when discussing your dental treatment. You must treat your abscesses in your mouth coming from your teeth. You have dental problems as a result of a medical problem. Your medical coverage probably excludes dental treatment except for certain surgeries. Try consulting with an oral surgeon or root canal specialist, an endodontist, to see if there are some codes that overlap between dental and medical conditions that can be utilized. In some instances, a refusal of coverage under a dental code allows submission to medical coverage. Keep open your discussion. Do not give up. This is a difficult area to address and they may stand on an exclusion clause, but I encourage you to continue to address with your documented medical condition. Thank you for your inquiry. I hope you are successful.