When is D7290 used?
The D7290 dental code applies to surgical tooth repositioning procedures. This CDT code is utilized when dental professionals perform surgery to relocate a tooth to a different position in the jaw, often due to injury, developmental problems, or severe misalignment that orthodontic treatment alone cannot fix. Typical uses include repositioning after dental trauma, fixing teeth that erupted in wrong locations, or moving teeth that block other teeth from erupting properly. D7290 differs from extraction codes or basic orthodontic procedures because it specifically involves surgical intervention to reposition teeth.
D7290 Charting and Clinical Use
Proper record-keeping is essential for D7290 billing. Clinical records must clearly document:
The condition requiring surgical repositioning (such as trauma displacement, impaction, or growth abnormalities).
Identification of affected teeth, including tooth numbers and their positions before and after treatment.
Surgical procedure details, including tissue flap approach, bone modification, repositioning technique, and stabilization methods like splinting.
Before and after X-rays or clinical photos when available to demonstrate treatment necessity.
Typical cases involve children with displaced front teeth from accidents, or canine teeth that emerged incorrectly and interfere with neighboring teeth. Complete documentation in all situations helps validate claims and prevents payment rejections.
Billing and Insurance Considerations
Successfully billing D7290 demands careful attention and clear insurer communication. Follow these guidelines:
Prior approval: Check patient coverage and obtain pre-approval when required, since surgical repositioning typically undergoes medical necessity review.
Include supporting materials: Submit clinical records, diagnostic images, and detailed explanations of why surgical repositioning was necessary over other treatment options.
Apply proper coding: Avoid mixing D7290 with extraction procedures (simple extraction) or impacted tooth exposure (exposure of an unerupted tooth).
Review payment statements: Check benefit explanations for correct payment amounts and denial explanations. When claims are rejected, use documentation for comprehensive appeals.
Manage receivables: Monitor outstanding claims by following up on unpaid submissions and resubmitting with extra documentation when needed.
How dental practices use D7290
A 10-year-old child comes in following a school accident that caused severe lateral displacement of an upper front tooth. The treating dentist concludes that standard orthodontic correction won't work due to displacement severity and potential harm to the developing tooth. Following parent approval and insurance pre-authorization, the dentist surgically moves the tooth back into position, secures it with splinting, and creates complete records with clinical notes and X-rays. The D7290 claim submission includes all supporting materials and receives insurance approval after their review process.
This case demonstrates the need for clinical reasoning, complete documentation, and careful billing procedures when applying the D7290 dental code.
Common Questions
Can D7290 be billed with other dental procedure codes?
Yes, D7290 may be reported together with other dental codes when multiple procedures occur during the same appointment. For instance, if exposing an unerupted tooth (D7280) is required prior to surgical repositioning, both codes can be billed. However, proper documentation must clearly differentiate each procedure and establish their medical necessity to prevent claim rejections due to unbundling issues.
What causes insurance companies to deny D7290 claims?
Frequent denial reasons include inadequate documentation, missing pre-authorization, incorrectly using D7290 for non-surgical repositioning procedures, or inability to establish medical necessity. Insurers may also reject claims when the procedure falls under orthodontic treatment exclusions or when trauma-related coverage is not included in the patient's plan. Comprehensive documentation with detailed narratives helps minimize claim denials.
What is the recommended retention period for D7290 documentation and imaging?
Dental offices should maintain all documentation, radiographs, and supporting materials for D7290 procedures according to state regulations and insurance contract requirements—generally 5 to 7 years minimum. Proper record retention is crucial for handling audits, processing appeals, and addressing any future inquiries about submitted claims.