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Odontoplasty might sound complex, but this procedure plays an important role in dental practices. Whether you're smoothing rough edges after orthodontic treatment or adjusting minor occlusal issues, understanding D9971 helps your office bill accurately and avoid claim denials. The procedure involves selectively removing small amounts of enamel to improve tooth contours, and knowing when to use this code protects your practice from billing errors while supporting patient care. This guide explains when D9971 applies, what documentation you need, and how to handle common billing challenges with this frequently misunderstood code.
Nov 1, 2025
What is Dental Code D9971?
D9971 represents odontoplasty, a procedure that involves the removal or reshaping of enamel surfaces or projections. This code applies when dentists reshape tooth structure by removing enamel without replacing it with restorative materials. The procedure focuses on minor contouring work performed on one or two teeth at a time.
The code falls under the Adjunctive General Services category in the Current Dental Terminology (CDT) system published by the American Dental Association (ADA). Unlike restorative procedures that rebuild teeth with fillings or crowns, odontoplasty is purely subtractive. You're removing enamel to improve form, function, or comfort.
Common Terminology
The dental field uses several terms interchangeably when discussing this procedure, though they all refer to D9971. Understanding these variations helps when reviewing treatment plans, communicating with insurance carriers, or training staff.
Enameloplasty: Describes the selective removal or contouring of enamel surfaces to change tooth length, shape, or surface characteristics
Tooth reshaping: A patient-friendly term that explains the procedure without technical jargon, often used during treatment discussions
Dental contouring: Another accessible term that describes the process of smoothing or adjusting tooth surfaces
Selective grinding: Clinical terminology that refers to the controlled removal of specific enamel areas to correct occlusal or aesthetic issues
Spot grinding: A focused approach to removing localized enamel projections or irregularities
When is D9971 Used?
D9971 applies in specific clinical situations where minor enamel adjustment addresses functional or aesthetic concerns. The procedure requires minimal tooth structure removal and focuses on refinement rather than reconstruction. Dentists typically perform odontoplasty as a standalone service or as an adjunct to other treatments when enamel reshaping supports the overall treatment plan.
Common Clinical Scenarios
Odontoplasty addresses various dental conditions that benefit from enamel reduction or reshaping. These situations represent the most frequent applications of D9971 in general and specialized dental practices.
Post-orthodontic smoothing: After removing braces or completing clear aligner therapy, teeth may have minor ridges or uneven edges that require contouring for optimal aesthetics and patient comfort
Minor chip repair: Small chips on tooth edges can be smoothed rather than restored when the damage doesn't extend into dentin or compromise tooth structure
Sharp edge elimination: Rough or sharp enamel projections that irritate soft tissues or create discomfort during normal oral function need smoothing
Occlusal adjustment: Teeth that create premature contacts or interfere with proper bite alignment may require selective enamel removal to improve occlusion
Pre-sealant preparation: Smoothing deep fissures or removing enamel irregularities before placing pit and fissure sealants improves retention and reduces microleakage
Interproximal reduction (IPR): Creating space between teeth during orthodontic treatment by removing small amounts of enamel from contact areas
Aesthetic refinement: Adjusting tooth contours to improve smile symmetry, such as rounding pointed canines or leveling uneven incisal edges
Trauma-related corrections: Smoothing enamel fractures or irregularities resulting from dental injuries when restoration isn't necessary
When D9971 is NOT Appropriate
Understanding when not to use D9971 prevents coding errors and claim denials. Several procedures involve enamel removal but require different codes based on the extent of work or the addition of restorative materials.
Significant tooth reduction: Procedures requiring substantial enamel removal for crown or veneer preparation use different codes specific to those restorative treatments
Procedures involving dentin: Any work extending beyond the enamel layer requires restorative codes rather than D9971
Restorative work: Adding any material to replace removed tooth structure means you're performing a restoration, not odontoplasty
Full-mouth occlusal equilibration: Comprehensive bite adjustments involving multiple teeth across several appointments require different codes that reflect the scope of treatment
Esthetic recontouring with composite: If you add composite material after enamel removal, bill for the appropriate restoration code instead of D9971
Major cosmetic reshaping: Extensive alterations to tooth shape or size typically involve veneers or other restorative options with their own specific codes
Billing and Insurance Considerations
Billing D9971 correctly requires understanding how insurance carriers view this procedure and what documentation supports claims. Most carriers classify odontoplasty as limited coverage, and many consider it cosmetic unless you demonstrate functional necessity. Proper billing practices start before treatment and continue through claim submission and follow-up.
Documentation Requirements
Strong documentation separates successful claims from denials when billing D9971. Your clinical notes must paint a clear picture of why odontoplasty was necessary and what you accomplished during treatment.
Detailed clinical notes: Record the specific teeth treated using proper tooth numbering, the clinical indication for treatment, the approximate amount of enamel removed, and the technique used during the procedure
Pre-treatment assessment: Document the presenting condition with descriptions of sharp edges, irregularities, occlusal interferences, or aesthetic concerns that justify treatment
Treatment rationale: Explain why odontoplasty was the appropriate treatment choice rather than alternative approaches or more extensive restorative work
Procedure specifics: Note the instruments used, the extent of enamel removal, and any additional procedures performed during the same appointment
Post-treatment condition: Describe the outcome, including improved contours, elimination of sharp edges, or resolution of functional issues
Photographic documentation: Include intraoral images showing before and after conditions when possible, particularly for cases where insurance coverage may be questioned
Patient communication: Document discussions about cosmetic versus functional benefits, especially when aesthetic improvement is the primary goal
Insurance Coverage
Insurance coverage for D9971 varies widely among carriers and depends heavily on whether the procedure addresses functional needs or purely cosmetic desires. Understanding coverage patterns helps set patient expectations and reduces billing surprises.
Limited coverage status: Most dental plans classify D9971 as a limited or non-covered procedure, particularly when performed for aesthetic reasons alone
Medical necessity requirement: Carriers that do cover odontoplasty typically require clear documentation of functional problems such as soft tissue irritation, occlusal trauma, or discomfort
Trauma and accident coverage: Some plans reimburse D9971 when the procedure follows dental trauma or accidental injury with proper documentation and narrative
Orthodontic package inclusion: Odontoplasty performed as part of orthodontic treatment finishing may be included in the overall orthodontic fee rather than billed separately
Pre-authorization recommendations: Submit pre-treatment estimates with supporting documentation when coverage is uncertain to avoid patient billing disputes
Alternative benefit considerations: If your plan doesn't cover implant-related services, ask about alternative benefits for similar procedures that might apply
Frequency limitations: Check specific plan documents for restrictions on how often D9971 can be billed per tooth or within specific timeframes
Common Billing Mistakes
Avoiding frequent errors improves reimbursement rates and reduces claim processing delays. These mistakes appear regularly in dental billing audits and create unnecessary administrative work.
Using D9971 for extensive tooth reduction: Billing odontoplasty when you're actually performing crown or veneer preparation misrepresents the procedure and invites denials
Incorrect quantity reporting: D9971 covers one to two teeth per code submission, so treating three teeth requires reporting D9971 twice
Bundling with other procedures: Some carriers consider odontoplasty inclusive of other treatments performed the same day, particularly when done as preparation for additional services
Missing clinical justification: Submitting claims without detailed narratives explaining medical necessity leads to cosmetic classification and denial
Inadequate documentation: Failing to specify which teeth received treatment or the extent of enamel removal creates processing delays and information requests
Duplicate billing: Reporting D9971 multiple times for the same tooth within a short period raises red flags and audit risks
Confusion with related codes: Mixing up D9971 with other contouring or reshaping codes that have different clinical applications results in inaccurate claims
Common Questions
How often can D9971 be billed per tooth?
No standard frequency limitation exists for D9971 across all insurance carriers, but most consider it a one-time or occasional procedure per tooth. Billing multiple times for the same tooth within the same year raises questions about treatment necessity. Check individual plan documents for specific restrictions, and document clear clinical justification if subsequent treatments become necessary due to new trauma, orthodontic changes, or developing occlusal issues.
Is there a waiting period between D9971 procedures?
Most dental plans don't impose specific waiting periods for odontoplasty since many classify it as non-covered or limited coverage. However, billing D9971 multiple times in quick succession for the same treatment area may trigger reviews. When legitimate clinical need requires multiple odontoplasty procedures, document the distinct reasons for each treatment and space procedures according to clinical necessity rather than arbitrary timelines.
Can D9971 be billed per tooth or per arch?
D9971 bills on a per-tooth basis, covering one to two teeth per code submission. If you treat three teeth, you report D9971 twice. Four teeth require two submissions, and so on. Never bill D9971 per arch or quadrant, as this misrepresents the code's intended use and likely triggers denials or downcoding during claims processing.
Does D9971 require radiographic documentation?
Radiographs aren't typically necessary for odontoplasty documentation since the procedure involves only enamel removal visible through clinical examination. However, radiographs showing pre-existing conditions like fractures, chips, or structural irregularities can support medical necessity claims when insurance coverage is questionable. Consider taking radiographs when trauma preceded the procedure or when occlusal relationships require documentation.
Can D9971 be used during orthodontic treatment?
Yes, odontoplasty frequently occurs during orthodontic treatment for interproximal reduction or finishing procedures. However, billing practices vary. Some orthodontists include tooth reshaping in their comprehensive treatment fee rather than billing D9971 separately. When performed as a finishing procedure on the same day braces are removed, the service may be considered inclusive of orthodontic care. Document separately when odontoplasty addresses issues unrelated to active orthodontic treatment.
What's the difference between D9971 and D2980?
D9971 (odontoplasty) involves only enamel removal without replacement, while D2980 (crown repair) addresses restoration of existing crowns or other prosthetic work. Using the wrong code constitutes insurance fraud. If you're smoothing natural tooth enamel, use D9971. If you're repairing a crown or other restoration, use D2980 or another appropriate restoration code.
Is patient consent required before performing D9971?
All dental procedures require informed consent. For odontoplasty, clearly explain that enamel removal is permanent and irreversible. Discuss the functional versus cosmetic benefits, potential insurance coverage limitations, and out-of-pocket costs. Document this conversation in the patient record, particularly when treatment primarily addresses aesthetic concerns rather than functional problems.
Can multiple D9971 procedures be performed in one appointment?
Yes, you can perform odontoplasty on multiple teeth during a single visit. Bill appropriately based on the number of teeth treated: D9971 once for one to two teeth, twice for three to four teeth, and so on. Document each tooth treated and the specific indication for enamel removal to support the claim. Consider the clinical efficiency of grouping related contouring work during the same appointment when treatment planning.
Keep Your Practice Fully Staffed
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Whether you need temporary coverage for unexpected absences or you're looking to transition someone into a permanent role, Teero handles the complexity. Sign up for Teero today and discover how easy it is to maintain consistent staffing while your team manages the detailed work of proper coding and claims processing.