Understanding Dental Code D3220

When to Use D3220 dental code

The D3220 dental code is designated for a therapeutic pulpotomy, which is the removal of the coronal pulp tissue in a tooth, typically performed to alleviate pain and preserve the vitality of the remaining radicular pulp. This code is used exclusively for permanent teeth and does not include the final restoration. D3220 is most appropriate when the pulp exposure is due to caries or trauma, and the tooth is restorable. It should not be confused with a root canal procedure or with pulpotomies on primary teeth, which have their own codes. Proper use of D3220 ensures accurate reporting and reimbursement for the specific clinical service provided.

Documentation and Clinical Scenarios

Accurate documentation is crucial when billing D3220. Clinical notes should clearly state the diagnosis (such as irreversible pulpitis), the reason for the pulpotomy, and the tooth number treated. Include details about the extent of decay or trauma, the steps taken during the pulpotomy, and any medicaments used. Photographs or radiographs supporting the diagnosis and treatment are highly recommended for the patient record and potential insurance audits. Common clinical scenarios include a young permanent molar with deep caries but no periapical pathology, or a traumatic pulp exposure in a child or adolescent where root development is incomplete.

Insurance Billing Tips

To maximize reimbursement and minimize denials for D3220, follow these best practices:

• Verify coverage: Check the patient’s dental benefits for pulpotomy coverage, as some plans may restrict this code to certain age groups or tooth types.
• Submit detailed narratives: Include a narrative explaining the clinical necessity, such as “Therapeutic pulpotomy performed due to carious exposure on permanent tooth #19 to preserve vitality.”
• Attach supporting documentation: Upload pre- and post-operative radiographs and intraoral photos with the claim.
• Use correct codes for related procedures: Bill the final restoration separately using the appropriate restorative code, and reference other codes (e.g., anterior root canal therapy) if treatment escalates.
• Monitor EOBs and AR: Review Explanation of Benefits carefully for denial reasons and appeal promptly with additional documentation if needed.

Example Case for D3220

Consider an 11-year-old patient presenting with spontaneous pain on a lower first molar. Clinical and radiographic exam reveals deep caries with pulp exposure, but no signs of abscess or periapical pathology. The dentist performs a therapeutic pulpotomy, removes the coronal pulp, places a medicament, and seals the chamber. The final restoration (such as a composite or crown) is scheduled for a subsequent visit and billed separately. In this scenario, D3220 is the correct code for the pulpotomy, and thorough documentation supports the claim for insurance reimbursement.