When is D7320 used?
The D7320 dental code is designated for alveoloplasty performed independently from tooth extractions. This CDT code applies when a dental professional contours and refines the alveolar ridge (the bone structure supporting teeth) to facilitate prosthetic placement, such as dentures, but not during the same visit as tooth removal procedures. Correct application of D7320 is vital for precise billing practices and to secure proper compensation for surgical work completed separately from extraction procedures.
D7320 Charting and Clinical Use
Supporting a D7320 claim requires comprehensive documentation. Clinical records must clearly show:
The purpose for the alveoloplasty (e.g., uneven ridge contours, prosthetic preparation)
Confirmation that the procedure occurred independently from extractions
Specifics of the treatment area (quadrant or arch location)
Pre- and post-treatment radiographs or clinical photographs when available
Medical justification, such as prosthetic fitting challenges or ongoing tissue irritation
Typical clinical situations involve patients with prior extractions requiring ridge contouring for improved prosthetic adaptation, or individuals with bone irregularities creating comfort or functional problems.
Billing and Insurance Considerations
Effective billing for D7320 demands careful attention and proactive insurer communication. Consider these practical approaches:
Check coverage beforehand: Validate alveoloplasty benefits within the patient's dental insurance, as certain plans may impose frequency restrictions or demand pre-approval.
Provide complete documentation: Include clinical records, imaging studies, and detailed explanations of procedure necessity and separate timing from extractions.
Apply proper coding practices: Avoid pairing D7320 with extraction procedures like D7210 unless treatments occur at separate appointments with proper documentation.
Examine EOBs carefully: When claims face denial, identify causes like insufficient documentation or inappropriate bundling with prior extractions. Be ready to file appeals with additional supporting materials when necessary.
Monitor outstanding claims: Keep track of pending reimbursements and pursue timely follow-up to minimize payment delays.
How dental practices use D7320
A patient underwent complete posterior tooth removal six months prior and now requires full denture fabrication. During prosthetic assessment, the dentist identifies prominent bony projections in the mandibular arch that would compromise denture retention. The practitioner performs mandibular alveoloplasty, creates thorough documentation, and files a D7320 claim. Supporting materials include before-and-after clinical images, detailed treatment rationale, and verification that no concurrent extractions occurred. The insurance carrier approves payment, and the patient achieves satisfactory denture comfort and function.
Through proper understanding of D7320 dental code application, dental practices can maintain billing accuracy, reduce claim rejections, and deliver superior patient outcomes.
Common Questions
Is it possible to bill D7320 multiple times for different treatment areas during a single visit?
Yes, D7320 may be billed for each separate area or quadrant where alveoloplasty is performed, provided that each location is thoroughly documented and not related to extractions performed on the same date. Make sure to clearly identify the specific treatment locations in your clinical documentation and claim submission.
What are the typical reasons insurance companies deny D7320 claims?
Typical denial reasons include inadequate documentation, missing narrative explaining the medical necessity, submitting D7320 alongside extraction codes for the same location and date, or the procedure not being covered under the patient's insurance plan. Examining the Explanation of Benefits (EOB) and providing additional supporting documentation can help address these denials.
Do D7320 procedures require pre-authorization from insurance?
Pre-authorization requirements differ among insurance providers. Certain plans may mandate pre-authorization for alveoloplasty procedures, particularly when performed for prosthetic preparation purposes. It is recommended to verify with the patient's insurance company before treatment to determine pre-authorization requirements and prevent potential claim delays or rejections.