Understanding Dental Code D7290

When to Use D7290 dental code

The D7290 dental code is designated for the surgical repositioning of teeth. This CDT code should be used when a dentist or oral surgeon performs a procedure to physically move a tooth to a new position within the jaw, typically due to trauma, developmental anomalies, or severe malposition that cannot be corrected with orthodontics alone. Common indications include repositioning following dental injuries, correcting ectopically erupted teeth, or addressing teeth that are blocking eruption paths for other teeth. It is important to distinguish D7290 from codes related to extractions or simple orthodontic movement, as D7290 specifically refers to a surgical intervention.

Documentation and Clinical Scenarios

Accurate documentation is crucial when billing for D7290. Clinical notes should clearly describe:

• The diagnosis necessitating surgical repositioning (e.g., traumatic displacement, impaction, or developmental issue).
• The specific tooth or teeth involved, including tooth numbers and positions before and after the procedure.
• Details of the surgical technique, such as flap design, bone removal, repositioning method, and stabilization (e.g., splinting).
• Pre- and post-operative radiographs or photographs, if available, to support the clinical necessity.

Common scenarios include a child with a displaced incisor after trauma, or a canine that has erupted in an abnormal position and is impeding adjacent teeth. In each case, thorough documentation supports the claim and reduces the risk of denial.

Insurance Billing Tips

Billing D7290 requires attention to detail and proactive communication with payers. Here are best practices:

• Pre-authorization: Always verify the patient’s benefits and seek pre-authorization when possible, as surgical repositioning is often reviewed for medical necessity.
• Attach supporting documentation: Include clinical notes, diagnostic images, and a narrative explaining why surgical repositioning was required instead of alternative treatments.
• Use correct coding: Do not confuse D7290 with codes for extractions (simple extraction) or exposure of impacted teeth (exposure of an unerupted tooth).
• Monitor EOBs: Review Explanation of Benefits statements for payment accuracy and denial reasons. If denied, use the documentation to submit a thorough claim appeal.
• Track AR: Stay on top of accounts receivable by following up on unpaid claims and resubmitting with additional documentation if necessary.

Example Case for D7290

A 10-year-old patient presents after a playground accident, resulting in a laterally displaced maxillary central incisor. The dentist determines that orthodontic repositioning is not feasible due to the severity of displacement and risk to the developing tooth. After obtaining parental consent and pre-authorization, the dentist surgically repositions the tooth, stabilizes it with a splint, and documents the entire process with clinical notes and radiographs. The claim is submitted with code D7290, including all supporting documentation, and is approved by the insurer after review.

This example highlights the importance of clinical justification, thorough documentation, and proactive billing practices when using the D7290 dental code.