Understanding Dental Code D7321

When to Use D7321 dental code

The D7321 dental code refers to alveoloplasty not in conjunction with extractions. This CDT code is used when a dentist performs surgical reshaping and smoothing of the alveolar ridge (the bony ridge in the mouth that holds the teeth) in areas where teeth have already been removed previously. It is not appropriate to use D7321 when alveoloplasty is performed at the same time as extractions—those scenarios require different codes, such as D7310 or D7311. D7321 is most commonly indicated when preparing a patient’s mouth for a prosthesis, such as a denture, or to address bony irregularities that interfere with oral function or comfort.

Documentation and Clinical Scenarios

Accurate documentation is essential for successful billing and insurance reimbursement of D7321. Clinical notes should clearly describe:

• The specific area(s) where alveoloplasty was performed
• Why the procedure was necessary (e.g., for prosthetic preparation, to relieve undercuts, or to improve tissue adaptation)
• That the procedure was not performed in conjunction with extractions
• Pre- and post-operative findings, including any radiographs or intraoral photos

Common clinical scenarios include:

• Reshaping a bony ridge months or years after extractions to allow for better denture fit
• Smoothing sharp bony edges causing discomfort under an existing prosthesis
• Correcting irregularities that have developed due to bone resorption

Insurance Billing Tips

To maximize claim acceptance for D7321, follow these best practices:

• Verify patient benefits before treatment to confirm coverage for alveoloplasty procedures not associated with extractions.
• Submit detailed clinical documentation with the claim, including the narrative, radiographs, and photos when possible.
• Use the correct CDT code—do not substitute D7321 for procedures performed during extractions.
• If the claim is denied, review the EOB for specific denial reasons and prepare a targeted appeal with additional supporting documentation.
• Keep a record of all communications with the payer for efficient AR follow-up.

Many payers require a narrative explaining why the alveoloplasty was necessary and confirming that it was not performed at the time of extraction. Including this information up front can reduce delays and denials.

Example Case for D7321

Scenario: A patient presents with discomfort under their lower denture. Clinical examination and radiographs reveal sharp, irregular bony ridges in the edentulous mandibular arch, where extractions were completed over a year ago. The dentist determines that alveoloplasty is needed to smooth the ridge and improve prosthesis fit.

Billing Steps:

1. Verify the patient’s insurance benefits for D7321.
2. Document the clinical findings, including photos and radiographs, and note that no extractions are being performed.
3. Submit the claim with D7321, attaching the narrative and supporting images.
4. If the claim is denied, review the EOB, address any missing information, and submit an appeal with additional documentation as needed.

This approach ensures accurate billing and increases the likelihood of timely reimbursement for the procedure.