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Surgical extractions form a critical part of oral surgery, but knowing when to use the right code can be confusing. D7210 covers a specific type of extraction that requires more than simple elevation and forceps. This guide breaks down when to use dental code 7210, what documentation you need, and how to avoid common billing mistakes.
Oct 24, 2025
What is Dental Code D7210?
D7210 represents surgical removal of an erupted tooth requiring elevation of a mucoperiosteal flap and removal of bone or sectioning of the tooth. This code applies when a tooth has broken through the gum line but needs surgical intervention beyond a simple extraction. The procedure involves cutting and lifting gum tissue, removing bone around the tooth, or dividing the tooth into pieces for removal.
Official Definition
The American Dental Association defines D7210 as "surgical removal of erupted tooth requiring elevation of mucoperiosteal flap and removal of bone and/or section of tooth." This code differs from D7140, which covers simple extractions that don't require these additional surgical steps. The key distinction lies in the surgical techniques needed to access and remove the tooth safely.
Common Terminology
Dental offices often refer to D7210 procedures as "surgical extractions" or "flap extractions." Some practices call them "bone removal extractions" when significant bone must be removed to access the tooth. Patients might hear these procedures described as "complex extractions" or "surgical tooth removal," though these terms aren't clinically precise.
When is D7210 Used?
The decision to use D7210 depends on the surgical techniques required during the extraction. You need to evaluate each case individually based on tooth position, root structure, and the approach needed for safe removal. Clinical judgment plays a major role in determining whether a tooth qualifies for this code versus a simpler extraction code.
Common Clinical Scenarios
D7210 applies when removing a fully erupted tooth with curved or divergent roots that require sectioning. The code covers extractions where significant bone removal is necessary to create adequate access for tooth elevation. You would use this code for teeth with hypercementosis that can't be removed with forceps alone. Fractured teeth at the gum line often need surgical flap elevation and bone removal, making them appropriate for D7210. Ankylosed teeth that have fused to the surrounding bone require surgical intervention that falls under this code.
When D7210 is NOT Appropriate
Simple extractions that only need forceps and elevation instruments should be coded as D7140. Teeth that come out easily without flap elevation or bone removal don't meet the criteria for D7210. Impacted teeth require different codes based on their position and the tissue covering them. Partially erupted teeth might qualify for impaction codes rather than D7210 if soft tissue or bone covers part of the crown.
Billing and Insurance Considerations
Proper documentation determines whether insurance will accept your D7210 claim. You need to show that the surgical techniques were medically necessary and actually performed during the procedure. Missing documentation is one of the most common reasons for claim denials on surgical extractions.
Documentation Requirements
Your clinical notes must describe the specific surgical techniques used during the extraction. Document that you elevated a mucoperiosteal flap and specify where you made the incision. Record any bone removal, including which burs you used and how much bone you removed. If you sectioned the tooth, note how many pieces you divided it into and why sectioning was necessary. Pre-operative radiographs should show root morphology, bone density, or other factors that required surgical intervention.
Insurance Coverage
Most dental insurance plans cover D7210 as a basic or major service, depending on the policy. Plans typically reimburse D7210 at higher rates than simple extractions because of the additional time and skill required. Some insurers require pre-authorization for surgical extractions, particularly on anterior teeth that usually extract simply. Coverage limits may apply to the number of surgical extractions allowed per year or per benefit period.
Common Billing Mistakes
Billing D7210 for every extraction without proper documentation leads to claim denials and potential audit flags. Some offices use this code when only forceps extraction was performed, which constitutes upcoding. Failing to differentiate between erupted tooth removal and impacted tooth removal causes confusion and rejected claims. Missing radiographic documentation or inadequate clinical notes about surgical techniques performed will result in downgrades to D7140.
Common Questions
How often can D7210 be billed?
Insurance plans don't typically limit how often you can bill D7210 for different teeth. You can perform and bill multiple surgical extractions in the same visit if each tooth requires surgical intervention. There are no standard waiting periods between D7210 procedures unless specified in the patient's individual plan.
Why does a surgical extraction cost more than a simple extraction?
The cost difference reflects the additional time, skill, and surgical techniques required for complex extractions. D7210 procedures involve flap elevation, bone removal, or tooth sectioning that simple extractions don't require. Some insurance plans classify surgical extractions as major services with higher copays than basic services.
Does D7210 apply to partially erupted teeth?
D7210 applies only to teeth that have erupted through the gum line, even if only partially visible. If bone or soft tissue covers the crown, you need to consider impaction codes instead. The determining factor is whether the tooth has broken through the tissue, not how much of the crown is visible.
Can you bill D7210 if you only section the tooth?
Sectioning the tooth alone doesn't automatically qualify the extraction for D7210. You must also elevate a mucoperiosteal flap or remove bone to meet the code requirements. The code description specifically includes "elevation of mucoperiosteal flap and removal of bone and/or section of tooth," meaning sectioning is one component, not the sole criterion.
What happens if insurance downgrades D7210 to D7140?
Insurance companies may downgrade claims when documentation doesn't support the surgical techniques required for D7210. You'll receive payment at the D7140 rate, which is typically lower than D7210 reimbursement. The patient becomes responsible for the difference between what you charged and what insurance paid.
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