Resources for dental offices
Tooth extraction leaves behind more than an empty socket. Without intervention, the alveolar ridge resorbs rapidly, compromising future implant placement and creating challenges for prosthetic restoration. D7953 addresses this challenge through bone replacement grafts placed at the time of extraction. Understanding when this code applies and how to document it properly protects your practice from claim denials while ensuring patients receive the ridge preservation care they need.
Nov 1, 2025
What is Dental Code D7953?
D7953 represents bone replacement grafting performed in conjunction with tooth extraction to preserve the alveolar ridge. This procedure involves placing graft material into the extraction socket immediately after removing the tooth, maintaining ridge height and width for future prosthetic or implant treatment.
The code covers the surgical placement of bone graft material, whether autogenous, allograft, xenograft, or alloplastic, into fresh extraction sites. Ridge preservation prevents the dimensional changes that typically occur during socket healing, reducing the need for more extensive ridge augmentation procedures later.
Common Terminology
The vocabulary surrounding ridge preservation procedures includes several technical terms that clarify what D7953 encompasses. Familiarity with these concepts helps distinguish this code from related surgical procedures.
Alveolar ridge preservation: Procedures that maintain bone volume following tooth extraction by placing graft material into the socket
Autogenous bone: Graft material harvested from the patient's own body, either from intraoral or extraoral sites
Allograft: Human bone tissue obtained from a tissue bank, processed and sterilized for grafting
Xenograft: Bone graft material derived from animal sources, typically bovine or porcine
Alloplastic graft: Synthetic bone substitute materials such as hydroxyapatite or calcium phosphate compounds
Membrane: Barrier material placed over the graft to protect it during healing and guide tissue regeneration
When is D7953 Used?
D7953 applies specifically to ridge preservation grafting performed at the time of tooth extraction. Timing distinguishes this code from other bone grafting procedures performed as separate surgical interventions weeks or months after extraction.
Common Clinical Scenarios
Ridge preservation becomes clinically indicated when maintaining bone volume serves the patient's long-term treatment goals. These situations justify the additional surgical step and associated costs.
Extractions in the aesthetic zone where ridge collapse would compromise the appearance of future restorations
Treatment plans that include future implant placement requiring adequate bone volume for fixture stability
Removal of teeth with significant periapical pathology that has already compromised surrounding bone
Cases involving thin buccal plates that are likely to resorb significantly without grafting intervention
Extraction sites that will support fixed prosthetics requiring stable ridge contours for optimal pontic design
Between these clinical applications and contraindications, the decision to perform ridge preservation balances immediate surgical considerations against long-term restorative objectives. Patient-specific factors guide whether grafting adds value to the extraction procedure.
When D7953 is NOT Appropriate
Certain extraction scenarios don't warrant ridge preservation grafting or require different procedural codes. Recognizing these situations prevents inappropriate billing and potential fraud allegations.
Simple extractions without any bone grafting material placement
Bone grafts placed during procedures other than extraction, such as sinus lifts or block grafts
Ridge augmentation performed weeks or months after extraction as a separate procedure (use D7950 or D7955 instead)
Grafting related to implant placement rather than extraction (use codes from the D6100 series)
Placement of collagen plugs or gelatin sponges without actual bone grafting material
Extractions where natural healing will provide adequate bone for the planned restoration
Billing and Insurance Considerations
Ridge preservation claims face intense scrutiny from insurance carriers who view these procedures as elective rather than medically necessary. Your documentation must establish clear clinical justification connecting the graft to the patient's comprehensive treatment plan, not just the isolated extraction procedure.
Documentation Requirements
Comprehensive records transform subjective treatment decisions into objective clinical necessity that insurance reviewers can evaluate fairly. Building this documentation trail starts before the extraction appointment.
Pre-operative radiographs showing the condition of the tooth and surrounding bone structures
Treatment plan notes explaining why ridge preservation serves the patient's long-term restorative needs
Operative notes detailing the extraction technique, graft material type and volume, and membrane placement if used
Post-operative radiographs demonstrating graft placement within the extraction socket
Records indicating whether the procedure was planned or became necessary due to unexpected surgical findings
Manufacturer information for the specific bone graft material used, including lot numbers when available
Insurance Coverage
Coverage for ridge preservation varies dramatically based on plan type and carrier philosophy regarding preventive bone grafting. Many plans exclude D7953 entirely, viewing it as preparatory to future elective procedures rather than treatment of current disease.
Medical plans sometimes cover ridge preservation when dental plans exclude it, particularly following trauma or pathology
Dental plans that do cover D7953 often impose strict documentation requirements and prior authorization mandates
Frequency limitations may restrict how many ridge preservation procedures are covered within specific time periods
Some carriers bundle D7953 with the extraction code, refusing separate reimbursement for the grafting component
Patient financial responsibility discussions before surgery prevent surprise bills when claims are denied
Between these varying coverage policies and the common bundling issues, practices must verify benefits specifically for D7953 rather than assuming extraction coverage includes grafting. Setting clear patient expectations about potential out-of-pocket costs protects the patient relationship when insurance denies claims.
Common Billing Mistakes
Ridge preservation billing errors stem from confusion about when the procedure truly occurred and what materials were actually placed. These mistakes trigger audits and recoupment demands that hurt practice finances.
Billing D7953 when only hemostatic agents or collagen plugs were placed without bone graft material
Using D7953 for grafts performed weeks after extraction rather than at the time of tooth removal
Failing to document the specific bone graft material type and volume in operative notes
Billing multiple units of D7953 when extracting several adjacent teeth but placing one continuous graft
Not obtaining prior authorization from carriers that require it before performing ridge preservation
Submitting claims without post-operative radiographs showing the graft material in the socket
Common Questions
Can D7953 be billed for every extraction where grafting is performed?
D7953 should be billed per extraction site that receives bone graft material, not per tooth extracted. If you extract three adjacent teeth and place bone graft across all three sockets as a single surgical site, most carriers consider that one unit of D7953.
Is ridge preservation covered by insurance?
Coverage varies widely. Some plans exclude D7953 completely, others require prior authorization and extensive documentation, and a few cover it routinely when medically necessary. Always verify benefits for this specific code before performing the procedure.
What's the difference between D7953 and D7956?
D7953 applies to ridge preservation at the time of extraction. D7956 covers guided tissue regeneration procedures that use barrier membranes as the primary therapeutic intervention. If you're primarily placing membrane for regeneration rather than grafting bone for preservation, D7956 may be more appropriate.
Do I bill D7953 separately from the extraction code?
Yes, D7953 is billed in addition to the appropriate extraction code (D7140, D7210, D7220, D7230, D7240, or D7241). However, some insurance carriers bundle these codes and reimburse only the extraction, so verify the patient's specific plan benefits.
Can I use D7953 if I'm placing an implant at the same time as extraction?
No. When placing an implant immediately after extraction, grafting around the implant is considered part of the implant surgery and billed using codes from the D6100 series. D7953 applies only when grafting for ridge preservation without simultaneous implant placement.
How do I handle claims when the carrier bundles D7953 with the extraction?
Document your attempt to bill both codes with clear notes about the distinct procedures performed. If the carrier bundles them, you must collect any unpaid balance from the patient as long as you disclosed the potential for non-coverage before performing the surgery.
Does the type of graft material affect which code to use?
No. D7953 applies regardless of whether you use autogenous bone, allograft, xenograft, or alloplastic materials. The material type should be documented in your clinical notes but doesn't change the procedure code.
Keep Your Surgical Schedule Running Without Interruption
Surgical procedures like ridge preservation require skilled assistants who understand grafting protocols and can anticipate your needs throughout the procedure. Staffing gaps on surgery days force you to reschedule patients or work with unfamiliar team members who slow down your workflow.
Teero gives you access to experienced dental professionals who can step into your schedule without missing a beat. Fill open shifts quickly, maintain your productivity, and deliver consistent patient care even when regular staff members are unavailable. Sign up for Teero today and build a reliable backup team for your busiest surgical days.