Understanding Dental Code D3355

When to Use D3355 dental code

The D3355 dental code is designated for pulpal regeneration—a biologically based procedure intended to restore vitality to an immature, non-vital permanent tooth. This code is specifically used when a dentist or endodontist performs regenerative endodontic therapy, typically in pediatric or adolescent patients, to encourage continued root development and strengthen the tooth structure. D3355 should not be confused with traditional root canal therapy or apexification procedures; it is reserved for cases where the goal is to regenerate pulp tissue rather than simply seal the canal.

Documentation and Clinical Scenarios

Proper documentation is critical when billing D3355. Clinical notes should clearly outline the diagnosis (such as necrotic pulp in an immature tooth), the rationale for choosing pulpal regeneration over other endodontic treatments, and a detailed description of the procedure performed. Include radiographs, pulp testing results, and any materials used (e.g., scaffolds, growth factors). Common clinical scenarios include trauma to a developing tooth or carious exposures in young patients where root development is incomplete. Ensure that all supporting documentation is attached to the claim to minimize denials and facilitate prompt reimbursement.

Insurance Billing Tips

When billing D3355, always verify coverage with the patient’s dental insurance prior to treatment, as regenerative procedures may have limited benefits or require pre-authorization. Submit a detailed narrative with the claim, highlighting the medical necessity and expected outcomes. Attach pre- and post-operative radiographs and any supporting documentation. If the claim is denied, review the Explanation of Benefits (EOB) for the reason and be prepared to submit a claim appeal with additional clinical justification. Track the claim in your accounts receivable (AR) system and follow up regularly until payment is received.

Example Case for D3355

Consider a 10-year-old patient who suffered dental trauma resulting in a non-vital upper central incisor with an open apex. The dentist determines that pulpal regeneration is the best course of action to promote continued root development. The procedure is performed, and all steps—including the use of regenerative materials and follow-up radiographs—are documented. The dental office submits a claim using D3355, includes a comprehensive narrative and supporting images, and receives reimbursement after a brief review by the insurer. This case highlights the importance of thorough documentation, proper code selection, and proactive communication with payers when utilizing D3355.