Understanding Dental Code D7981

When to Use D7981 dental code

The D7981 dental code is designated for the excision of a salivary gland, and is reported with detailed documentation. This CDT code is used when a dental provider removes a salivary gland—typically due to chronic infection, obstruction, or neoplastic growths that cannot be managed by less invasive means. It is important to note that D7981 is not for simple excision of minor salivary gland tissue or for incision and drainage procedures; those scenarios may require different codes, such as D7910 for simple excision of a lesion. Always confirm the clinical necessity and ensure the procedure matches the code description before selecting D7981.

Documentation and Clinical Scenarios

Proper documentation is critical when billing D7981. Your clinical notes should include:

• The patient’s diagnosis and symptoms (e.g., chronic sialadenitis, obstructive sialolithiasis, or suspected neoplasm).
• Imaging or diagnostic tests supporting the need for gland removal.
• A detailed operative report describing the gland excised (parotid, submandibular, or sublingual), the surgical approach, and any complications or findings.
• Postoperative care instructions and follow-up plan.

Common clinical scenarios include chronic infection unresponsive to conservative therapy, recurrent obstructive stones, or biopsy-proven tumors. In each case, thorough documentation supports the medical necessity of the excision and strengthens your claim.

Insurance Billing Tips

Billing for D7981 requires attention to detail to ensure prompt reimbursement and minimize denials:

• Preauthorization: Most dental and medical plans require preauthorization for gland excision. Submit clinical notes, imaging, and a clear rationale for surgery.
• Cross-coding: Since salivary gland excision is sometimes considered a medical procedure, be prepared to cross-code with the appropriate CPT code if the patient’s dental plan denies coverage. Coordinate with the patient’s medical insurance as needed.
• Attachments: Always include supporting documentation (radiographs, pathology reports, operative notes) with your claim submission.
• Claim follow-up: Monitor your accounts receivable (AR) for timely payment. If an Explanation of Benefits (EOB) indicates denial, review the reason code and file a claim appeal with additional documentation if warranted.

Successful dental offices establish a workflow for insurance verification, preauthorization, and timely claim submission to maximize reimbursement for complex surgical codes like D7981.

Example Case for D7981

Case Example: A 52-year-old patient presents with recurrent swelling and pain in the right submandibular area. Imaging reveals a large sialolith obstructing the duct, with chronic infection. Conservative management has failed. The oral surgeon documents the diagnosis, reviews imaging, and obtains preauthorization. The gland is excised under general anesthesia, with detailed operative notes and pathology submitted. The claim is filed with D7981, including all supporting documentation. The dental office follows up with insurance, responds to a request for additional information, and ultimately receives payment after a successful appeal.

This real-world scenario highlights the importance of thorough documentation, preauthorization, and diligent follow-up when billing for D7981.