When is D3432 used?
The D3432 dental code represents guided tissue regeneration using a resorbable barrier, per site, performed alongside periradicular surgery. This code applies specifically to procedures where dental professionals place a resorbable membrane to promote bone and periodontal tissue regeneration around tooth roots during periradicular (root-end) surgical procedures. D3432 is appropriate only when utilizing a resorbable barrier material during surgical treatment for endodontic pathology, including procedures like apicoectomy or root-end resection. This code should not be applied to non-surgical treatments or procedures involving non-resorbable barriers (refer to D4266 for non-resorbable membrane procedures).
D3432 Charting and Clinical Use
Proper documentation is critical for successful D3432 reimbursement. Clinical records must include:
Clinical diagnosis and justification for tissue regeneration therapy during periradicular surgery
Surgical procedure specifics, including affected tooth number, treatment site, and defect characteristics
Resorbable barrier specifications (manufacturer, material composition, and batch information when available)
Before and after radiographic images demonstrating the defect and treatment results
Patient informed consent and procedure explanation documentation
Typical clinical applications involve ongoing periapical pathology, root-end bone defects, or apical bone loss following unsuccessful endodontic treatment. Placing a resorbable membrane prevents soft tissue interference and promotes bone healing, enhancing the surgical site's long-term success.
Billing and Insurance Considerations
To optimize reimbursement and reduce claim rejections for D3432, dental billing staff should:
Confirm coverage details before treatment—numerous dental insurance policies restrict or exclude GTR procedures, particularly when combined with endodontic surgery.
Provide complete documentation with claims, including treatment notes, radiographic evidence, and detailed explanations of medical necessity for resorbable barrier placement.
Apply the appropriate CDT code (D3432) and prevent coding errors. When non-resorbable barriers are utilized, reference D4266 instead.
Examine EOBs (Explanation of Benefits) thoroughly for rejection explanations and prepare appeals with supporting documentation when necessary.
Monitor AR (Accounts Receivable) to maintain prompt follow-up on outstanding or underpaid claims.
Effective practices typically maintain standardized protocols for GTR procedures to ensure complete documentation before claim processing.
How dental practices use D3432
Practice Example: A 45-year-old patient has a continuing periapical infection on tooth #14 after previous endodontic treatment. The specialist recommends periradicular surgery combined with guided tissue regeneration. During the procedure, a resorbable collagen barrier is positioned over the bone defect to support healing. Complete documentation includes before and after radiographs plus detailed treatment notes. The D3432 claim receives insurance approval following review of the thorough documentation package.
This scenario demonstrates the significance of accurate coding, comprehensive clinical records, and effective insurance coordination when processing D3432 claims.
Common Questions
What distinguishes resorbable from non-resorbable barriers in guided tissue regeneration procedures?
Resorbable barriers are engineered to naturally break down and be absorbed by the body over time, which eliminates the requirement for an additional surgical procedure to remove them. Non-resorbable barriers, however, require surgical removal once tissue healing is complete. The D3432 code is exclusively applicable when a resorbable barrier is utilized during periradicular surgical procedures.
Is it possible to bill D3432 alongside other surgical procedures performed during the same visit?
D3432 may be billed per site when guided tissue regeneration using a resorbable barrier is conducted during periradicular surgery. When additional procedures are performed at separate sites, the corresponding CDT codes for those procedures should be applied. Nevertheless, code unbundling for identical sites or utilizing D3432 for unrelated procedures is prohibited.
What steps should dental practices take for D3432 preauthorization to reduce claim denials?
Dental practices should secure preauthorization from the patient's insurance carrier prior to performing the procedure to reduce claim denials. This process requires submitting comprehensive clinical documentation, including radiographic images and a detailed narrative demonstrating the medical necessity for guided tissue regeneration with a resorbable barrier. Verifying coverage beforehand facilitates smoother reimbursement processes and decreases the likelihood of claim rejections.