When is D7550 used?
The D7550 dental code is designated for partial ostectomy/sequestrectomy procedures involving the removal of dead or non-vital bone tissue. This CDT code applies when dental professionals need to extract portions of necrotic bone from the jaw area, typically resulting from infection, injury, or complications following dental treatments. D7550 should be differentiated from other surgical procedures like complete ostectomy or standard extractions, as this code is specifically for cases requiring partial bone removal that involves more complexity than routine tooth extraction procedures.
D7550 Charting and Clinical Use
Proper documentation plays a crucial role in ensuring appropriate reimbursement when applying D7550. Patient records must clearly indicate the presence of dead bone tissue, describe the scope of removal, and explain the underlying cause (such as osteomyelitis, implant site failure, or post-extraction issues). Supporting evidence like X-rays or clinical photographs should be maintained in patient files to validate the diagnosis and treatment necessity. Typical applications for D7550 include:
Extracting bone sequestrum (necrotic bone pieces) after tooth removal
Addressing localized bone infection
Resolving complications from prior oral surgical procedures or injury
Ensure your clinical records align with claim narratives to reduce the likelihood of payment denials.
Billing and Insurance Considerations
Before submitting D7550 claims, confirm patient insurance coverage for oral surgical procedures. Present comprehensive claims including thorough documentation such as clinical records, imaging studies, and detailed explanations of medical necessity. When the procedure relates to previously billed treatments, reference prior claims and clarify why further intervention became necessary. Prepare for potential requests for supplementary information and understand the appeals process for claim denials. Effective dental practices typically follow this approach:
Obtain pre-authorization when feasible, including all relevant documentation upfront.
File claims quickly with comprehensive narratives and required supporting materials.
Monitor claim progress through your accounts receivable system and contact insurers if processing exceeds 30 days.
Submit appeals without delay if claims are rejected, including any additional documentation insurers request.
Appropriate application of D7550 helps optimize reimbursement and streamline your practice's revenue management.
How dental practices use D7550
A patient returns with ongoing discomfort and inflammation weeks following molar removal. Imaging studies show bone sequestrum with non-vital tissue at the extraction location. The practitioner records these observations, captures clinical images, and completes partial ostectomy/sequestrectomy to eliminate the necrotic bone. Documentation includes detailed descriptions of the dead tissue extent, surgical approach, and patient recovery progress. The D7550 claim submission incorporates comprehensive supporting materials and narrative connecting to the initial extraction procedure. Insurance approval follows, with prompt payment processing, highlighting how complete documentation and accurate coding facilitate successful reimbursement.
For information about related surgical procedures like complete ostectomy, consult our D7260 coverage for additional information.
Common Questions
How does a partial ostectomy (D7550) differ from a complete ostectomy in dental treatment?
A partial ostectomy under code D7550 involves removing only a portion of diseased or dead bone tissue, commonly performed when dealing with infection, injury, or compromised healing. A complete ostectomy, however, requires removing an entire bone section or larger bone area and uses different billing codes. Code D7550 is reserved exclusively for limited, localized bone removal procedures and should never be applied when complete bone structures are excised.
When should D7550 not be applied due to patient conditions or clinical contraindications?
Code D7550 is inappropriate for standard tooth extractions, situations lacking evidence of dead bone tissue, or when bone removal doesn't involve surgical excision of necrotic material. This code also shouldn't be used when bone removal is part of a broader surgical intervention that has its own specific coding. Practitioners must verify that the clinical situation aligns with the code's purpose and that the patient's condition justifies performing a partial ostectomy or sequestrectomy.
What is the expected reimbursement timeframe for D7550 claims and which elements influence processing speed?
Processing times for D7550 reimbursement claims depend on the insurance provider, documentation quality, and pre-authorization requirements. Typically, claims process within 2-4 weeks when proper documentation is submitted initially. Processing delays may result from insufficient documentation, insurer requests for additional details, or the need for appeals following initial claim rejections.