Understanding Dental Code D7820

When to Use D7820 dental code

The D7820 dental code is designated for the closed reduction of dislocation in the dental setting. This CDT code is used when a patient presents with a dislocated temporomandibular joint (TMJ) or other maxillofacial joint, and the provider performs a non-surgical, manual repositioning of the joint back into its normal alignment. It is important to note that this code is only appropriate when the procedure is performed without surgical intervention—meaning no incisions or open approaches are used. Common clinical scenarios include acute TMJ dislocations due to trauma, yawning, or excessive mouth opening during dental procedures.

Documentation and Clinical Scenarios

Accurate documentation is critical when billing for D7820. The clinical notes should clearly describe the dislocation event, symptoms (such as pain, inability to close the mouth, or jaw deviation), and the steps taken to achieve reduction. Include details such as:

• Date and time of the incident
• Mechanism of injury or cause of dislocation
• Physical findings (e.g., jaw locked open, palpable joint displacement)
• Technique used for closed reduction
• Patient response and post-procedure stability

Supporting documentation, such as pre- and post-reduction radiographs or photographs, can strengthen the claim and support medical necessity. In some cases, the use of adjunctive sedation or local anesthesia should also be documented and coded appropriately.

Insurance Billing Tips

When billing D7820, dental offices should follow these best practices to maximize reimbursement and minimize denials:

• Verify benefits: Before treatment, confirm the patient’s dental and medical coverage for TMJ-related procedures. Some policies may require pre-authorization or may only cover under medical insurance.
• Submit detailed claims: Attach comprehensive clinical notes, radiographs, and any supporting documentation to the claim. Clearly indicate the necessity for closed reduction and any complications.
• Use correct coding: If sedation or anesthesia was used, include the appropriate CDT codes for those services. If the dislocation required an open (surgical) reduction, use the correct code for open reduction instead.
• Appeal denials: If a claim is denied, review the Explanation of Benefits (EOB) for the reason, and submit a thorough appeal with additional documentation if needed. Highlight the urgency and necessity of the procedure.

Timely and accurate Accounts Receivable (AR) follow-up is essential to ensure claims are processed and paid efficiently.

Example Case for D7820

Case: A 35-year-old patient presents to your dental office after experiencing jaw locking and pain following a wide yawn. Examination reveals anterior dislocation of the TMJ. The dentist performs a closed reduction, successfully restoring normal jaw function. Clinical notes document the incident, findings, reduction technique, and patient outcome. Pre- and post-reduction photos are included in the patient record. The claim is submitted with D7820, supported by all relevant documentation, and is promptly reimbursed by the insurance carrier.

This example highlights the importance of thorough documentation, proper code selection, and proactive insurance communication when billing for D7820.