Understanding Dental Code D3427

When to Use D3427 dental code

The D3427 dental code is designated for periradicular surgery without apicoectomy. This CDT code is used when a surgical procedure is performed to address periradicular pathology—such as cysts, granulomas, or other lesions—without the removal of the root apex (apicoectomy). It is important to distinguish this code from related procedures like apicoectomy (D3410), which specifically involves resecting the root tip. Use D3427 when the clinician surgically accesses the periradicular area to remove diseased tissue but leaves the root apex intact.

Documentation and Clinical Scenarios

Proper documentation is essential for successful insurance reimbursement. Clinical notes should clearly state the diagnosis, the reason for surgery, and why an apicoectomy was not performed. Include preoperative radiographs, intraoperative findings, and a detailed description of the surgical steps. Typical scenarios for D3427 include removal of a periapical cyst or granuloma where the root apex is healthy and does not require resection. Always document the absence of root-end resection to justify the use of D3427 instead of an apicoectomy code.

Insurance Billing Tips

When billing D3427, ensure your claim includes comprehensive clinical documentation and radiographic evidence. Attach a narrative that explains the pathology treated and clarifies why apicoectomy was not indicated. This reduces the risk of claim denial or requests for additional information. Verify patient benefits and coverage for surgical endodontic procedures during insurance verification. If a claim is denied, review the EOB for denial reasons and submit a detailed appeal with supporting documentation. Successful dental offices often use standardized templates for narratives and appeals to streamline the process and improve approval rates.

Example Case for D3427

Case: A patient presents with persistent swelling and discomfort near the apex of tooth #14. Radiographs reveal a periapical radiolucency consistent with a granuloma. The endodontist determines the root apex is healthy and only the granulomatous tissue requires removal. The clinician performs a periradicular surgery, excising the lesion without resecting the root tip. The procedure is documented with pre- and post-operative radiographs, and a narrative is included in the insurance claim to justify the use of D3427. The claim is processed and approved due to clear documentation and correct code selection.