Understanding Dental Code D7671

When to Use D7671 dental code

The D7671 dental code is designated for procedures involving the alveolus, specifically when there is an open reduction of a fracture without fixation. This CDT code is most commonly used in oral and maxillofacial surgery when a patient presents with an alveolar process fracture that requires repositioning but does not necessitate hardware or fixation devices. Dental teams should apply D7671 when the clinical situation involves realigning fractured bone segments of the alveolus to restore function and aesthetics, but where stabilization with plates, screws, or wires is not indicated.

Documentation and Clinical Scenarios

Accurate documentation is essential for successful reimbursement when billing D7671. The clinical notes should clearly describe the nature and location of the alveolar fracture, the method of reduction, and the absence of fixation. Include pre- and post-operative radiographs, detailed narrative reports, and intraoperative photos if available. Common scenarios for D7671 include trauma cases resulting from sports injuries, falls, or accidents where the alveolar bone is fractured but can be stabilized without hardware. Always document the patient’s symptoms, diagnostic findings, and the rationale for choosing open reduction without fixation over other treatment options, such as those described under D7260 (for surgical removal of residual tooth roots) or D7610 (for open reduction with fixation).

Insurance Billing Tips

To maximize claim acceptance for D7671, follow these best practices:

• Verify patient benefits: Confirm the patient’s coverage for oral surgery and trauma-related procedures before treatment. Many dental and medical plans may overlap in coverage for alveolar fractures.
• Submit comprehensive documentation: Attach clinical notes, radiographs, and a detailed narrative explaining the necessity for open reduction without fixation.
• Use the correct CDT code: Ensure D7671 is the most accurate code for the procedure performed. Misuse can lead to denials or delays.
• Appeal denied claims: If a claim is denied, review the Explanation of Benefits (EOB) for the reason, supplement with additional documentation, and submit a timely appeal.
• Coordinate benefits: If the patient has dual coverage (dental and medical), coordinate benefits to optimize reimbursement and reduce patient out-of-pocket costs.

Example Case for D7671

Case Scenario: A 14-year-old patient presents after a bicycle accident with a displaced alveolar fracture in the anterior maxilla. Clinical and radiographic evaluation confirms the diagnosis. The oral surgeon performs an open reduction, manually repositioning the fractured segment without the need for fixation devices. The procedure is documented with pre- and post-op radiographs, a detailed narrative, and intraoperative photos. The claim is submitted using D7671, with all supporting documentation attached. The insurance carrier approves the claim after initial review, and payment is posted to the patient’s account, minimizing AR days and ensuring timely revenue cycle completion.

This example highlights the importance of precise coding, thorough documentation, and proactive insurance communication when billing for D7671.