D7210: Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated
As explained by the experts at DentalRevu, if the extraction of an erupted tooth necessitates bone removal and/or tooth sectioning, submit the D7210 Dental Code, and not D7140. Typically, D7210 is reimbursed at a rate of 150–180 percent greater than D7140. The extra fee is justified by the fact that the removal technique takes more time and is more complex.
When justified, several general practitioners omit the extraction code D7210. The procedure counts for D7210 are typically a fraction of the procedure counts for “regular” extractions (D7140) at a conventional dentistry office. To learn more about D7210, check out the warnings, limitations, and narratives below:
What are the Warnings of the D7210 Dental Code?
It is deceptive to record D7210 for the extraction of an erupted tooth when the tooth is extracted without bone removal and/or dental sectioning and just a suture is inserted. D7210 necessitates bone removal and/or sectioning of the teeth. Do not record D7210 if no bone is removed and/or the tooth is not sectioned.
Suture placement does not elevate the extraction to the level of an erupted tooth extraction (D7210). D7210 requires the excision of bone and/or “sectioning of tooth.” By sectioning the tooth, the service is elevated to that defined in D7210. If warranted, the elevation of a mucoperiosteal flap is included in D7210.
Please Note: Reporting D7210 no longer requires elevation of a mucoperiosteal flap, but reporting D7210 is termed “upcoding,” which may be construed as a dishonest act if the tooth was simply elevated for removal (D7140).
What are the Limitations of the D7210 Dental Code?
- The global charge for D7210 includes suture placement and removal, minimal bone smoothing, closure, and routine follow-up. Treatment for widespread infection following tooth extraction may be a reimbursable service (D9930).
- When performed concurrently with an extraction, alveoloplasty is often regarded a part of the extraction. Incidental bone removal (D7210) is not considered a separate billable alveoloplasty treatment. If many nearby extractions are necessary or extensive bony recontouring is required, see alveoloplasty in conjunction with extractions (D7310/D7311).
- D7210 is used to indicate the completion of an extraction. Certain payers require submission of the more complicated D7210 procedure to the patient’s medical insurer prior to considering payment under the dental plan. Attach the medical explanation of benefits to the dental claim form if the claim has been submitted to the medical payer.
- The descriptor for D7210 specifies that either “bone removal” or “tooth sectioning” is sufficient reason to report D7210. Please Note: Certain payers may require both bone removal and tooth sectioning to qualify for payment. Certain payers need the laying of a mucoperiosteal flap to be performed in order to be reimbursed, despite the fact that the elevation of a mucoperiosteal flap is no longer required to report D7210, as stated in the code’s descriptor.
- To report difficult (post-surgical) circumstances such as widespread infection, see D9930. However, the majority of payers include D9930 (by the same office) in the worldwide extraction fee.
Additional Information about the D7210 Dental Code
- D7210 should be used carefully. In the clinical notes, accurately explain the process. A typical notation would read as follows: “elevated flap (if appropriate) and extracted bone and/or sectioned teeth. These steps were required in order to extract the tooth.”
- A photograph of the sectioned tooth taken with an intraoral camera is recommended to demonstrate that the treatment was performed and that the process qualifies as a D7210 extraction.
- Indicate whether bone was removed during the extraction and why it was necessary, e.g., the tooth was cracked below the bone level. “Please see the accompanying photograph.”
- Indicate whether the tooth was sectioned during extraction and why; for example, if the tooth had curved roots, sectioning was necessary to extract the tooth as painlessly as possible. “Please see the accompanying photograph.”
- A current diagnostic radiography image, as well as any supporting images, should be included in the documentation.
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