When is D7471 used?
The D7471 dental code applies to the surgical removal of lateral exostosis—abnormal bone growths—found on the maxilla (upper jaw) or mandible (lower jaw). This CDT code is appropriate when patients have benign bony projections that hinder oral function, prevent proper fitting of prosthetic devices, or create patient discomfort. This code excludes tori removal (refer to D7472 for palatal tori procedures) and basic bone shaping performed during standard tooth extractions.
D7471 Charting and Clinical Use
Proper record-keeping is crucial for successful insurance claims and payment processing. When applying D7471, the patient record must contain:
Comprehensive clinical documentation noting the exostosis location, dimensions, and related patient symptoms.
X-ray confirmation (including panoramic or periapical images) that validates the diagnosis.
Before and after photographs where feasible, demonstrating treatment necessity.
Surgical report detailing the method used, type of anesthesia administered, and any procedural complications.
Typical situations for D7471 involve patients unable to wear dentures comfortably due to bone overgrowth, or individuals experiencing ongoing irritation from the bony prominence.
Billing and Insurance Considerations
Effective billing practices for D7471 can enhance payment success and minimize claim rejections. Consider these recommendations:
Check coverage details prior to treatment by contacting the patient's insurance provider to confirm D7471 exostosis removal benefits.
Include complete documentation with claims, featuring clinical records, X-rays, and detailed explanations of treatment necessity.
Apply accurate CDT codes and prevent incorrect coding practices. When performing additional treatments (such as alveoloplasty), code these separately with proper documentation.
For claim denials, examine the EOB (Explanation of Benefits) carefully and prepare appeals with extra supporting evidence, including necessity letters or specialist recommendations.
How dental practices use D7471
A 62-year-old patient visits the office reporting discomfort with their lower partial denture. Clinical examination shows a significant bony projection on the mandible's buccal surface. X-ray images confirm lateral exostosis presence. Following insurance verification, the dental staff records all findings, captures pre-treatment images, and requests pre-authorization. The surgical procedure proceeds using local anesthesia with complete exostosis removal. Post-treatment documentation and photographs are filed in the patient chart. The insurance claim includes all supporting evidence, leading to timely payment approval.
Following these guidelines and mastering the specifics of the D7471 dental code helps dental offices maintain proper billing practices, reduce claim rejections, and deliver excellent patient treatment results.
Common Questions
Can D7471 be billed with other surgical procedures, and what's the proper approach?
D7471 may be billed with additional surgical codes when multiple procedures occur in the same visit, including bone grafting or alveoloplasty. Each procedure requires separate documentation with clear clinical rationale and supporting evidence such as radiographs, photographs, and detailed narratives. List each code individually on the claim with corresponding documentation to prevent bundling complications or claim rejections.
What are typical reasons for D7471 claim denials beyond insufficient documentation?
Insurance carriers may reject D7471 claims when the procedure lacks medical necessity, when patient benefits exclude exostosis removal coverage, or when documentation fails to demonstrate functional impairment or patient discomfort. Additional denials occur when the code is incorrectly applied to minor bone irregularities or inappropriately substituted for other surgical procedures.
What post-operative documentation should be maintained following D7471 procedures?
Following exostosis removal under D7471, document patient recovery progress, any complications encountered, and functional outcomes regarding oral comfort or prosthetic adaptation. Post-operative records should detail healing advancement, patient comfort levels, and any additional treatments required. This documentation ensures proper care continuity and provides necessary information for potential insurance follow-up requests.