Understanding Dental Code D7320

When to Use D7320 dental code

The D7320 dental code refers to alveoloplasty not in conjunction with extractions. This CDT code is used when a dentist reshapes and smooths the alveolar ridge (the bone that holds the teeth) to prepare for prosthetic devices, such as dentures, but not during the same appointment as tooth extractions. Proper use of D7320 is essential for accurate billing and to ensure appropriate reimbursement for the surgical procedure performed independently of extractions.

Documentation and Clinical Scenarios

To support a claim for D7320, thorough documentation is crucial. The clinical notes should clearly indicate:

• The reason for the alveoloplasty (e.g., irregular ridge, pre-prosthetic preparation)
• That the procedure was performed not in conjunction with extractions
• Details of the area treated (quadrant or arch)
• Pre- and post-operative radiographs or intraoral images, if available
• Any medical necessity, such as difficulty with denture fit or chronic irritation

Common clinical scenarios include patients who have previously had extractions and now require ridge modification for a better prosthetic fit, or those with bony irregularities causing discomfort or functional issues.

Insurance Billing Tips

Successful billing for D7320 requires attention to detail and proactive communication with payers. Here are actionable steps:

• Verify benefits before treatment: Confirm coverage for alveoloplasty under the patient’s dental plan, as some policies may have frequency limitations or require prior authorization.
• Submit comprehensive documentation: Attach clinical notes, radiographs, and a narrative explaining why the procedure was necessary and performed separately from extractions.
• Use correct coding: Do not combine D7320 with extraction codes like D7210 unless both procedures are performed at different times and documented accordingly.
• Review EOBs (Explanation of Benefits): If the claim is denied, check for reasons such as lack of documentation or bundling with previous extractions. Prepare to submit a claim appeal with additional supporting evidence if needed.
• Track AR (Accounts Receivable): Monitor outstanding claims and follow up promptly to reduce payment delays.

Example Case for D7320

Consider a patient who had all posterior teeth extracted six months ago and is now ready for a full denture. During the prosthetic evaluation, the dentist notes sharp bony ridges in the lower arch that will interfere with the denture fit. The dentist performs alveoloplasty on the lower arch, documents the procedure, and submits a claim using D7320. The claim includes pre- and post-op photos, a narrative explaining the medical necessity, and confirmation that no extractions were performed at the same visit. The insurance approves the claim, and the patient receives a comfortable-fitting denture.

By understanding when and how to use the D7320 dental code, dental teams can ensure accurate billing, minimize claim denials, and provide optimal patient care.