When is D7660 used?
The D7660 dental code applies to surgical procedures involving the malar bone and/or zygomatic arch, primarily for repairing facial bone fractures. This CDT code is frequently utilized by oral and maxillofacial surgeons when treating patients with trauma or injuries affecting the cheekbone (malar) or zygomatic arch structures. Selecting the correct code is vital for proper reimbursement and meeting insurance compliance standards. Apply D7660 exclusively when clinical records clearly demonstrate surgical treatment of these particular facial bone structures, avoiding its use for minor injuries or procedures beyond bone repair scope.
D7660 Charting and Clinical Use
Proper documentation is critical when submitting claims with D7660. The patient's medical record must contain:
Comprehensive clinical notes detailing the injury's nature and severity
Imaging evidence (including panoramic or CT scans) confirming the diagnosis
Complete surgical documentation describing the procedure, approach, fixation techniques, and any implanted materials
Pre-operative and post-operative evaluations
Typical clinical situations for D7660 involve automobile accidents, athletic injuries, or accidental falls causing displaced or fragmented fractures of the malar or zygomatic arch. When other facial bones are affected, you might need to consider additional codes, such as D7670 for maxillary fractures.
Billing and Insurance Considerations
To optimize reimbursement and reduce processing delays, implement these recommended practices when billing D7660:
Benefits Verification: Validate the patient's coverage and preauthorization needs for oral surgical procedures. Most insurance plans mandate prior approval for trauma-related treatments.
Claims Processing: Include all relevant documentation, such as clinical records, imaging studies, and surgical reports. Provide clear, detailed narratives demonstrating medical necessity.
Payment Review: Thoroughly examine the Explanation of Benefits for payment correctness and rejection reasons. For underpayments or denials, submit a comprehensive appeal with additional supporting documentation.
Benefits Coordination: For accident-related injuries, coordinate appropriately with medical insurance or third-party liability providers.
Maintaining proactive documentation and communication practices helps dental practices prevent common billing errors and accelerate accounts receivable processing.
How dental practices use D7660
Clinical Example: A 32-year-old individual arrives following a cycling accident with facial swelling and asymmetry. Physical examination and diagnostic imaging reveal a displaced left zygomatic arch fracture. The oral surgeon conducts open reduction and internal fixation utilizing titanium plates and screws. The treatment, documentation, and imaging are submitted with the insurance claim using D7660. The insurance company initially requests supplementary records, but the comprehensive surgical report and imaging evidence support quick approval and complete payment.
This case demonstrates how thorough documentation and prompt follow-up contribute to successful D7660 claim processing.
Common Questions
Is the D7660 dental code applicable for non-traumatic medical conditions?
No, the D7660 code is exclusively designated for open reduction procedures involving malar and/or zygomatic arch fractures that result from traumatic incidents like accidents, athletic injuries, or falls. This code is not suitable for addressing non-traumatic issues or congenital abnormalities affecting these facial bone structures.
Is it possible to bill D7660 together with other surgical procedure codes?
Yes, D7660 can be billed in conjunction with other procedure codes when multiple separate surgical interventions are conducted within the same operative session, such as addressing additional facial fracture repairs. However, it must not be used to separate services that are inherently part of the same surgical technique. It's essential to review payer-specific guidelines to prevent duplicate billing or improper unbundling practices.
What are the typical causes for claim denials when using code D7660?
Frequent denial causes include inadequate clinical documentation, missing pre-authorization requirements, incorrect insurance submission (submitting to dental coverage instead of medical insurance), or failure to establish medical necessity. To minimize claim rejections, ensure thorough clinical documentation, appropriate diagnostic imaging, and clear justification demonstrating why open reduction treatment is medically required.