Understanding Dental Code D7670

When to Use D7670 dental code

The D7670 dental code is a Current Dental Terminology (CDT) code used to report alveolus procedures—specifically, the placement of a synthetic graft or biologic material to repair or augment the alveolar ridge. This code is most commonly applied after traumatic dental injuries, extractions, or in preparation for prosthetic devices. Dental teams should select D7670 when the clinical intent is to restore the alveolar ridge’s form and function, not for routine extractions or socket preservation, which may require different codes. Always verify the clinical necessity and ensure the procedure aligns with the code’s definition before submitting claims.

Documentation and Clinical Scenarios

Accurate documentation is essential for successful reimbursement of D7670. The patient’s chart should include:

• Detailed clinical notes describing the defect or trauma to the alveolus
• Pre- and post-operative radiographs or intraoral photos
• The type and amount of grafting material used
• Rationale for the procedure (e.g., trauma repair, prosthetic preparation)

Common clinical scenarios include:

• Repair of alveolar defects following traumatic injury
• Augmentation of the ridge prior to placement of a fixed or removable prosthesis
• Correction of congenital or acquired alveolar deficiencies

For procedures involving socket preservation after extraction, consider whether D7953 (bone graft for ridge preservation) is more appropriate.

Insurance Billing Tips

To maximize reimbursement and minimize denials for D7670, follow these best practices:

• Pre-authorization: Submit a detailed pre-treatment estimate with supporting documentation (radiographs, clinical notes, photos) to the insurance carrier.
• Claim Submission: Include a narrative explaining the necessity of alveolar repair, the materials used, and the intended outcome.
• Coordination of Benefits: If the patient has dual coverage, coordinate benefits to ensure proper payment sequencing.
• Appeals: If a claim is denied, review the Explanation of Benefits (EOB) for denial reasons, supplement with additional documentation, and submit a timely appeal.

Always verify the patient’s benefits and exclusions for grafting procedures during insurance verification to set proper expectations and avoid surprises.

Example Case for D7670

Case: A patient presents with a traumatic injury resulting in a loss of alveolar bone structure in the anterior maxilla. The dentist documents the defect with pre-op photos and radiographs. After discussing options, the provider performs an alveolar repair using a synthetic graft, documenting the material, lot number, and rationale for the procedure. The dental biller submits a claim using D7670, attaches all supporting documentation, and includes a narrative describing the trauma and the need for ridge restoration to support a future prosthesis. The insurance carrier approves the claim after reviewing the comprehensive documentation.

This example highlights the importance of thorough documentation, correct code selection, and proactive communication with payers to ensure successful reimbursement for D7670 procedures.