Insurance narrative for occlusal guard

An insurance narrative for an occlusal guard, listing codes D9944, D9945, and D9946. Written as a letter from the dentist, it describes a patient with severe bruxism found during an oral evaluation, citing morning jaw pain, grinding and clenching with sensitivity, and visible enamel wear with hairline fractures. It asks that the patient’s dental benefits cover the appliance and invites the payer to contact the office.

Attach it to the claim when the guard is billed. The doctor or billing coordinator should rewrite the findings to match what the exam showed for this patient, add the patient details, and keep a copy in the chart.