Understanding Dental Code D7220

When to Use D7220 dental code

The D7220 dental code is designated for the removal of an impacted tooth, specifically when the tooth is partially bony impacted. This means that part of the tooth is covered by bone and requires surgical intervention for extraction. Dental teams should use D7220 when the clinical and radiographic evidence shows that the tooth cannot be removed without cutting through bone and/or sectioning the tooth. Commonly, this code applies to third molars (wisdom teeth) but may be used for any tooth meeting the criteria.

Documentation and Clinical Scenarios

Accurate documentation is essential for proper reimbursement and compliance. When billing D7220, ensure the patient’s chart includes:

• Detailed clinical notes describing the impaction (e.g., partial bony coverage, symptoms, and findings)
• Radiographs (such as panoramic or periapical X-rays) clearly showing the impacted tooth and bone involvement
• Pre- and post-operative notes outlining the surgical approach and any complications

Typical scenarios for D7220 include partially erupted wisdom teeth causing pain, infection, or orthodontic complications, where bone removal is necessary. If the tooth is completely covered by bone, consider D7240 for full bony impaction. For soft tissue impactions, refer to D7210.

Insurance Billing Tips

To maximize claim acceptance and minimize denials, follow these best practices:

• Verify benefits: Confirm the patient’s coverage for oral surgery and any frequency limitations before treatment.
• Submit complete documentation: Attach clinical notes and radiographs to the claim. Many payers require visual proof of bone involvement for D7220.
• Use accurate narratives: Write a concise narrative explaining why D7220 is the appropriate code, including the extent of impaction and surgical necessity.
• Track EOBs and AR: Monitor Explanation of Benefits (EOBs) and Accounts Receivable (AR) to quickly identify and appeal denied or underpaid claims.
• Appeal when necessary: If a claim is denied, review the payer’s reason, supplement with additional documentation, and submit a timely appeal.

Example Case for D7220

Case: A 19-year-old patient presents with pain and swelling around a partially erupted lower third molar. Radiographs reveal that the tooth is partially covered by bone, with evidence of pericoronitis. The dentist determines that surgical extraction is required, involving bone removal and tooth sectioning.

Billing steps:

1. Document the clinical findings and attach X-rays showing the partial bony impaction.
2. Submit the claim with D7220, including a narrative: “Extraction of partially bony impacted tooth #32 due to pain and infection. Bone removal and tooth sectioning performed.”
3. Track the claim status and respond promptly to any payer requests for additional information.

This approach ensures accurate billing, supports medical necessity, and streamlines reimbursement for surgical extractions under D7220.