Insurance & Fees
At Arlington Tongue Tie Center, we are dedicated to providing gentle and quality care for infants and children. We understand the importance of ensuring a clear understanding of our financial policies. That’s why we’ve made our financial process straightforward and transparent. Below you will find detailed information about our financial process and what you can expect when seeking care at our office.
Our professional fees are $250 for a consultation.
The cost of treatment is $750 for one frenectomy site, and $1,500 for two or more sites. The maximum charge for treatment is $1,500. There is no charge for follow up appointments within the first three months of treatment.
All fees are due at the time of the appointment.
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We understand that many of our families would like to utilize benefits from their medical and dental insurance for the frenectomy procedure. We are happy to help with this process! We will provide you with all necessary information.
Detailed information is listed below.
DENTAL INSURANCE
On the day of the procedure, we will provide you with an itemized receipt and a claim form to submit to your dental insurance for reimbursement. A narrative and electronic images are also made available to you. If this procedure is covered under your dental insurance plan, you will be responsible for submitting the claim and pursuing reimbursement directly. Coverage is dependent on your specific insurance plan. Any payments made by your dental insurance will be sent to you directly.
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Codes for Reimbursement:
ADA Codes
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D9310 - Consultation
D7961 - Frenectomy - Upper Lip and Cheek
D7962 - Frenectomy - Tongue
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MEDICAL INSURANCE
On the day of the procedure, we will provide you with a letter of medical necessity, which will include all pertinent Diagnosis (ICD-10 codes), Treatment (CPT codes), narrative explanations and fees that can be submitted along with your claim. You will also be provided with an itemized receipt of payment. You are responsible for submitting the claim and pursuing reimbursement directly. Coverage is dependent on your specific insurance plan. Any payments made by your medical insurance will be sent to you directly.
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Codes for Reimbursement:
ICD 10 and CPT Codes
ICD 10 Code: Diagnosis of Ankyloglossia (Tongue Tie) Q38.1
ICD 10 Code: Diagnosis of Restricted Labial Frenulum (Lip Tie) Q38.0
Procedure CPT Code: Consultation: 99245
Procedure CPT Code: Lingual (Tongue) Frenulum / Frenotomy: 41115
Procedure CPT Code: Labial or Upper Lip Frenulum / Frenotomy: 40819
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Dr. Allison Lonneman NPI: 1376042242