When is D7240 used?
The D7240 dental code is applied for extracting impacted teeth that are completely surrounded by bone and require surgical intervention. This CDT code is appropriate when the impacted tooth is entirely encased in bone tissue, making it necessary to create a mucoperiosteal flap, remove surrounding bone, and section the tooth for extraction. While D7240 is frequently applied to third molars (wisdom teeth), it can be used for any tooth that meets these specific impaction criteria. Proper application of D7240 helps ensure appropriate reimbursement and maintains compliance with dental insurance requirements.
D7240 Charting and Clinical Use
Comprehensive documentation is crucial when submitting claims for D7240. Clinical records must clearly indicate the degree of impaction (complete bony), the surgical necessity, and detailed procedural steps performed. Preoperative imaging, including panoramic or periapical radiographs, should be included to show the tooth's position and impaction level. Your clinical documentation should outline the surgical technique, including flap creation, bone removal, and tooth sectioning procedures. Typical applications for D7240 include extracting horizontally or mesioangularly impacted third molars completely embedded in bone, or other teeth with comparable impaction patterns requiring surgical management.
Billing and Insurance Considerations
To improve claim approval rates for D7240, implement these strategies:
Check benefits: Validate patient coverage and any limitations on surgical extractions prior to treatment.
Provide complete documentation: Include clinical records, radiographic images, and intraoral photographs to substantiate the claim.
Apply correct coding: Avoid inappropriate coding; use D7240 exclusively for fully bony impacted teeth requiring surgical extraction. For soft tissue impactions, consider D7220 or D7230 instead.
Handle claim rejections: When claims are denied, examine the explanation of benefits, collect supporting documentation, and file a comprehensive appeal outlining the medical necessity for D7240.
Thorough documentation practices and effective payer communication can substantially decrease accounts receivable days and enhance payment outcomes.
How dental practices use D7240
A 25-year-old patient arrives with discomfort and inflammation in the lower right posterior region. Panoramic imaging shows a horizontally positioned mandibular third molar completely embedded in bone. Following insurance verification, the dentist records the surgical approach: creating a full-thickness mucoperiosteal flap, removing buccal and distal bone tissue, sectioning the tooth, and performing careful extraction. Complete clinical documentation and imaging are submitted with the D7240 claim. The insurance company approves the claim and processes payment efficiently due to proper documentation and accurate code usage.
Common Questions
What causes D7240 claims to be denied most frequently?
D7240 claim denials typically occur due to inadequate documentation (missing X-rays or incomplete clinical records), lack of demonstrated medical necessity, incorrect procedure coding, or missing required pre-authorizations. To minimize denials, include comprehensive supporting documentation and detailed clinical narratives with each claim submission.
Is it possible to bill D7240 with other procedures during the same appointment?
D7240 can be billed with other procedures when they are medically necessary and distinctly separate services. For instance, bone grafting or suturing performed alongside the extraction should be coded and documented as individual procedures. Always verify payer-specific bundling policies and restrictions before submitting multiple procedure codes.
What is the proper billing approach for complications following a D7240 procedure?
When post-operative complications develop, such as infections or dry socket conditions, additional treatments typically require distinct billing codes. Thoroughly document the complication and treatment rendered, then submit claims using appropriate codes with comprehensive supporting documentation. Note that some insurers include limited post-operative care within the D7240 global fee, so verify the patient's coverage details and payer policies before billing additional services.