When is D7250 used?
The D7250 dental code represents "removal of residual tooth roots (cutting procedure)" based on CDT (Current Dental Terminology) standards. This code applies when patients have leftover root pieces in the jawbone following prior extractions or injury, requiring surgical removal through cutting methods. The code is not suitable for routine extractions or cases where the complete tooth remains intact. D7250 is designated for circumstances involving only root portions, where the procedure includes tissue flap creation, bone tissue removal, or root sectioning for thorough extraction.
D7250 Charting and Clinical Use
Proper record-keeping is essential for D7250 billing. Dental professionals must ensure clinical records clearly document retained root presence, removal rationale, and surgical procedures performed. X-ray images should accompany claims to validate retained root fragments. Typical clinical situations for D7250 include:
Root remnants from challenging extractions requiring subsequent surgical removal appointments.
Fractured root tips resulting from injury or prior dental work.
Root fragments found during routine X-ray examinations needing removal due to infection risk or prosthetic treatment planning.
Always distinguish D7250 from other extraction procedures, including routine extraction (D7140) or complex extraction (D7210), through careful documentation of clinical observations and treatment methods.
Billing and Insurance Considerations
To optimize payment and reduce claim rejections for D7250, implement these strategies:
Prior approval: Request pre-treatment authorization when appropriate, particularly for patients with complicated health conditions or restricted dental coverage.
Comprehensive descriptions: Provide clear, complete narratives explaining the necessity for root removal and detailing surgical techniques used.
Include supporting materials: Submit before and after X-rays along with relevant treatment notes. This documentation proves medical necessity and prevents processing delays.
Examine benefit statements: When claims are rejected, carefully analyze the explanation for denial reasons. Frequent problems involve insufficient documentation or mix-ups with other extraction codes. Prepare appeals by collecting all supporting materials and resubmitting with improved explanations.
Multiple insurance coordination: For patients with two insurance plans, ensure proper coordination between primary and secondary carriers to prevent payment complications.
How dental practices use D7250
Practice Example: A 58-year-old patient reports jaw discomfort in the lower left area. X-ray examination shows a remaining root piece from a back tooth extracted years earlier. The dentist creates a tissue flap, removes surrounding bone to reach the root, and carefully removes the fragment using surgical instruments. Treatment records document the root's presence, surgical method, and patient recovery instructions. The insurance submission includes D7250 coding, comprehensive treatment description, and pre- and post-treatment X-rays. The claim receives approval and payment processes smoothly.
This case demonstrates the value of complete documentation and proper dental billing procedures for D7250. Understanding the appropriate application of this code helps dental practices achieve accurate compensation and deliver quality patient treatment.
Common Questions
Is the D7250 dental code suitable for removing root tips in children?
Yes, D7250 is appropriate for pediatric patients when residual root fragments need to be removed through a cutting procedure. Just like with adult patients, thorough documentation and radiographic evidence are crucial to support the insurance claim.
Can D7250 be billed together with bone grafting or additional surgical procedures?
D7250 can be billed with other surgical procedures like bone grafting when both treatments are medically necessary and properly documented separately. Make sure to use correct codes for each procedure and provide comprehensive documentation to prevent claim bundling issues or denials.
What should a dental practice do when a D7250 claim gets denied for insufficient medical necessity?
When a D7250 claim is denied due to lack of medical necessity, first review the denial explanation, collect additional supporting evidence including annotated radiographs and comprehensive clinical notes, then file a prompt appeal. Including a detailed narrative that explains why the cutting procedure was necessary for root removal can help reverse the denial decision.