We strongly encourage all dentists performing surgical extractions to familiarize themselves with the description of these procedures in the 2011-2012 edition of the American Dental Association Code of Dental Terminology (CDT). To qualify as a surgical tooth removal, the clinical notes must indicate that “removal of erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap, if indicated” have been performed. If the clinical notes lack these elements, the claim will be re-coded as a D7140, extraction, erupted tooth or exposed root (elevation and/or forceps removal. Removal of soft tissue or a mucoperiosteal flap alone do not qualify the procedure for the D7210 code. Our consultants are also authorized to re-code procedures when the radiographs submitted do not support the claim for a surgical extraction (extensive bone loss, conical roots etc.).

Procedures for removal of impacted teeth will also be reviewed using similar criteria. To qualify as a partial or full bony impaction, radiographs must demonstrate that part or all of the crown is covered by bone as described for CDT Codes D7230, D7240, D7241, and D7250. Clinical notes must document bone removal to qualify as a bony impaction.

If you choose to submit a request for reconsideration, please do not send additional written narratives or corrected entries if the original clinical notes that you submitted do not reflect that services consistent with the code descriptions were performed at the time of service. 

Please refer to our Clinical Documentation requirements for additional information.

Thanks in advance for your cooperation. If you are not currently submitting electronic claims with attachments, please go to wwwtesia.com to learn about our money saving offer with Tesia- PCI.

Shannon E. Mills, DDS, Vice President,
Professional Relations and Science