When is D4283 used?
The D4283 dental code applies to autogenous connective tissue graft procedures that address each extra adjacent tooth, implant, or edentulous tooth location within the same grafting area, after the initial graft. This code is utilized when patients need soft tissue enhancement in regions next to the original grafted location, particularly when several teeth or implants are treated within one surgical area. D4283 must always be submitted alongside the initial graft code, commonly D4277 for the primary tooth, implant, or edentulous location in the grafting zone.
D4283 Charting and Clinical Use
Proper documentation is essential for successful payment of D4283. The patient record must clearly show:
The exact teeth, implants, or edentulous areas treated within the graft location
The initial site coded with D4277
The medical need for treating extra adjacent locations
Before and after images, gum measurements, and comprehensive surgical documentation
Typical situations involve patients with widespread recession affecting multiple neighboring teeth, or when tissue grafting is required for several implants positioned consecutively. Make sure the treatment notes justify the medical requirement for each extra location coded under D4283.
Billing and Insurance Considerations
To improve payment rates and reduce claim rejections for D4283, implement these strategies:
Check benefits: Many insurance plans do not cover tissue grafts or multiple adjacent locations. Confirm coverage prior to treatment.
Provide complete records: Send treatment notes, images, and gum measurements with your claim submission.
Apply proper codes: Always combine D4283 with the correct initial graft code (D4277 or equivalent), and identify which teeth or areas match each code.
Challenge rejections: When claims are denied, examine the benefits explanation, supply extra documentation, and file an appeal with comprehensive notes and supporting materials.
Clear communication with insurance companies and complete record-keeping are vital for successful D4283 billing.
How dental practices use D4283
Take a patient with notable gum recession on teeth #6, #7, and #8. The specialist decides to perform an autogenous connective tissue graft covering all three teeth within one surgical area. The billing would include:
D4277: Autogenous connective tissue graft procedure for the primary tooth (such as tooth #6)
D4283: For each extra adjacent tooth (teeth #7 and #8) within the same grafting area
The treatment records should describe the recession severity, the surgical method, and the reason for grafting each location. Adding before and after images plus detailed treatment notes will strengthen the claim and increase payment chances.
Understanding proper application and documentation of the D4283 dental code helps dental offices ensure correct billing, minimize claim denials, and maximize income from specialized gum procedures.
Common Questions
Is it possible to bill D4283 independently without D4277?
D4283 cannot be billed as a standalone procedure code. This code must always be used together with D4277, which represents the primary graft site. The D4283 code is designated specifically for billing each additional contiguous tooth, implant, or edentulous area that receives treatment within the same graft site beyond what is covered by the initial D4277 code.
How many times can D4283 be billed during a single surgical procedure?
The CDT code system does not establish a universal maximum limit for billing D4283 in one procedure, but the quantity billed must accurately reflect the actual number of additional contiguous teeth, implants, or edentulous areas that received treatment. It's important to note that individual insurance carriers may establish their own coverage restrictions or frequency limitations, making it essential to verify patient benefits with the specific payer prior to performing treatment.
What documentation should be provided in a narrative when filing a claim for D4283?
When submitting a claim for D4283, the narrative should provide comprehensive clinical documentation including detailed descriptions of clinical findings such as recession measurements or tissue deficiency extent, the specific surgical technique employed, clear identification of all treated teeth or sites, clinical justification for grafting each additional location, and documentation of medical necessity for the procedure. Supporting materials such as clinical photographs and periodontal measurements should accompany this narrative to strengthen claim justification and enhance reimbursement probability.