Dental Care Coding is crucial for accurate billing and reimbursement, especially when dealing with complex procedures like impacted teeth removal. Within the Current Dental Terminology (CDT) codes, D7230 and D7240 are specifically designated for the removal of impacted teeth, differentiated by the extent of bony impaction. Understanding the nuances between these codes is essential for dental professionals to ensure correct claim submissions.
The American Dental Association (ADA) provides clear definitions to guide the selection between D7230 and D7240. According to the CDT Manual, the descriptions are as follows:
D7230 removal of impacted tooth – partially bony: This code applies when part of the anatomical crown of the tooth is covered by bone. The procedure necessitates a mucoperiosteal flap elevation and bone removal to access and extract the tooth.
D7240 removal of impacted tooth – completely bony: This code is used when most or all of the anatomical crown is covered by bone. Similar to D7230, this procedure also requires mucoperiosteal flap elevation and bone removal for tooth extraction.
To accurately apply these codes, it’s vital to understand the term “anatomical crown.” The ADA’s Glossary of Dental Clinical Terms defines the anatomical crown as: “That portion of tooth normally covered by, and including, enamel.” This definition clarifies that the crown, in the context of D7230 and D7240, refers to the enamel-covered part of the tooth above the cemento-enamel junction.
Based on this definition, the distinction between “partially bony” and “completely bony” impaction hinges on the extent to which the anatomical crown is encased in bone. “Part of the crown” in D7230 should be interpreted as less than 50% of the entire anatomical crown being covered by bone. Conversely, “most or all of the crown” in D7240 signifies that 50% or more of the anatomical crown is covered by bone.
It’s important to note that an incorrect interpretation sometimes arises, suggesting that D7240 is only applicable if a portion of the occlusal surface is below the bone level. The ADA clarifies that this is not the correct interpretation. The determining factor is the extent of the anatomical crown covered by bone, not the position of the occlusal surface relative to the bone.
Ultimately, the responsibility for selecting the appropriate code (D7230 or D7240) lies with the dentist performing the impacted teeth removal. They must consider the ADA’s guidance, the complete CDT code entries, and the specific clinical circumstances of each case to accurately reflect the service provided through dental care coding.
For further detailed guidance on coding for impacted teeth removal procedures, the ADA provides a downloadable resource.
Guidance on Coding for Impacted Teeth Removal Procedure (PDF)
