Understanding Dental Code D4283

When to Use D4283 dental code

The D4283 dental code is used for an autogenous connective tissue graft procedure that covers each additional contiguous tooth, implant, or edentulous tooth position in the same graft site, following the primary graft. This code is specifically applied when a patient requires soft tissue augmentation in an area adjacent to the initial grafted site, such as when multiple teeth or implants are involved in a single surgical field. It is important to note that D4283 is always billed in conjunction with the primary graft code, typically D4277 for the first tooth, implant, or edentulous site in the graft area.

Documentation and Clinical Scenarios

Accurate documentation is crucial for successful reimbursement of D4283. The clinical record should clearly indicate:

• The specific teeth, implants, or edentulous positions treated in the graft site
• The primary site billed with D4277
• The necessity for grafting additional contiguous sites
• Pre-operative and post-operative photos, periodontal charting, and detailed surgical notes

Common scenarios include patients with generalized recession across several adjacent teeth, or when soft tissue grafting is needed for multiple implants placed side by side. Always ensure the clinical narrative supports the medical necessity for each additional site billed under D4283.

Insurance Billing Tips

To maximize reimbursement and minimize denials for D4283, follow these best practices:

• Verify coverage: Not all dental plans cover soft tissue grafts or multiple contiguous sites. Confirm benefits before treatment.
• Submit comprehensive documentation: Include clinical notes, photographs, and periodontal charting with your claim.
• Use correct coding: Always pair D4283 with the appropriate primary graft code (D4277 or similar), and specify which teeth or sites correspond to each code.
• Appeal denials: If the claim is denied, review the Explanation of Benefits (EOB), provide additional documentation, and submit a claim appeal with a detailed narrative and supporting evidence.

Proactive communication with insurance carriers and thorough documentation are key to successful billing for D4283.

Example Case for D4283

Consider a patient presenting with significant gingival recession on teeth #6, #7, and #8. The periodontist plans an autogenous connective tissue graft across all three teeth in a single surgical site. The claim would be coded as follows:

• D4277: Autogenous connective tissue graft procedure for the first tooth (e.g., tooth #6)
• D4283: For each additional contiguous tooth (teeth #7 and #8) in the same graft site

The clinical documentation should detail the extent of recession, the surgical approach, and the necessity for grafting each site. Including pre- and post-operative photos and a clear narrative will support the claim and improve the likelihood of reimbursement.

By understanding the correct use and documentation of the D4283 dental code, dental teams can ensure accurate billing, reduce claim denials, and optimize revenue for advanced periodontal procedures.