Can I use Medisave for wisdom tooth surgery?

Wisdom tooth surgery is a common surgical procedure that many young patients have to undergo. Older patients may also need to have their wisdom teeth removed if they did not do it when they were younger. Cost of wisdom tooth surgery in Singapore can varying quite a fair bit, depending on the complexity of the case. As it is an essential surgery, Medisave can be used. There are several Medisave codes for wisdom tooth surgery, commensurate with the level of difficulty of the surgery. Let's take a look at how Medisave can be use for wisdom tooth surgery in Singapore.

All surgical procedures that are Medisave claimable are listed in a document published by the Ministry of Health call the Table of Surgical Procedures. There are thousands of procedures listed and each one is assigned a "table" ranging from 1A to 7C, in order of complexity and hence the amount of money that can be withdrawn from you Medisave account. 

For wisdom tooth surgery, there are ten codes, ranging from Table 1B to 4B, which allows for withdrawal of $350 to $2700 respectively. These codes can be subdivided into two categories:

1. Single tooth surgery

There are six codes describing single tooth surgery. The lowest code is not assigned a table, ie no Medisave claim is allowed. This relates to wisdom tooth that is almost fully erupted but covered by a layer of gum and surgery to remove it only entails making an incision on the overlying gum and elevating the tooth out without further surgery. The other codes entail increasing levels of difficulty of the surgery, for example, if bone needs to be removed, the Table will be higher, or if the tooth needs to be divided before it can be removed, the Table will correspondingly be higher again. In some rare cases, the wisdom tooth is entwined with a nerve in the jaw bone and needed to be separated from the nerve, the highest code can be used. Overall, the most common procedure for removing impacted wisdom tooth involves cutting the gum, removal of bone and division of tooth which is a Table 2C with a withdrawal limit of $950.

2. Multiple teeth surgery

If more than one tooth needs to be removed at the same sitting, the multiple teeth surgery codes must be used. There are codes for 2-3 teeth and codes for 4 teeth, each with increasing levels of difficulty. As with single tooth codes, the determination of level of difficulty is guided by whether bone removal and/or tooth division are needed. Very commonly, the two lower wisdom teeth are impacted and need removal of bone and division of teeth while the upper ones are normally erupted and can be extracted non-surgically. This combination qualifies for the code for 2-3 teeth which is a Table 3C, and the Medisave withdrawal limit is $1850. 

Audit

Even though Medisave is your own money, the Government is the custodian and it has drawn up rules governing its use. As such, the Ministry of Health carries out audits of Medisave claims to ensure that the claims are consistent with the rules. In an audit, if the dentist is found to have submitted a wrong code, restitution will be ordered. For example, if the dentist submitted a code for removal of a deeply impacted wisdom tooth, which is Table 3A ($1250), and the auditor finds that the tooth is actually superficial and that the appropriate codes only allows for Table 2C ($950), the dentist will have to refund the difference of $300 to the patient's Medisave account. The dentist may then collect the difference in cash from the patient. 

Ultimately, patients need to remember that the money in our Medisave account is our own money and we should use it as such. Dentists need to know the appropriate codes to use for the surgeries that they are claiming.