Understanding Dental Code D7983

When to Use D7983 dental code

The D7983 dental code is designated for the closure of a salivary fistula, a procedure often required when there is an abnormal connection between a salivary gland or duct and the oral cavity or skin. Dental teams should use D7983 when a patient presents with persistent salivary leakage following trauma, surgery, or infection that has resulted in a fistulous tract. Proper code selection is essential for accurate billing and ensures that the procedure is reimbursed appropriately. Always confirm that the clinical presentation matches the code’s intent and that no other CDT code more specifically describes the service provided.

Documentation and Clinical Scenarios

Accurate and thorough documentation is crucial when billing for D7983. The clinical notes should clearly describe:

• The location and etiology of the salivary fistula
• Relevant history, such as prior surgeries, trauma, or infection
• Diagnostic findings (e.g., imaging, clinical examination)
• The specific technique used for closure (e.g., surgical excision, layered closure)
• Post-operative instructions and follow-up plan

Common scenarios include closure after removal of a salivary gland stone, repair following oral cancer surgery, or correction of a persistent fistula after dental extractions. If another procedure is performed in conjunction, such as a bone graft (bone graft for ridge preservation), document each service separately and ensure each is medically necessary.

Insurance Billing Tips

To maximize reimbursement and minimize denials for D7983, dental billing teams should:

• Verify coverage: Check the patient’s benefits for oral surgery procedures and exclusions related to fistula repair.
• Pre-authorize when possible: Submit a detailed pre-authorization with clinical notes, radiographs, and a narrative explaining the medical necessity of the closure.
• Use proper attachments: Include intraoral photos, imaging, and operative reports with the claim.
• Appeal denials: If the claim is denied, review the Explanation of Benefits (EOB) for the denial reason, gather additional supporting documentation, and submit a clear, concise appeal letter referencing the CDT code description and clinical need.
• Track AR: Monitor accounts receivable closely for surgical codes, as these often require additional follow-up with payers.

Staying proactive with insurance verification and documentation helps prevent delays and ensures timely payment for complex surgical procedures like D7983.

Example Case for D7983

Case: A 58-year-old patient presents with persistent drainage from the lower jaw three weeks after mandibular molar extraction. Examination and imaging confirm a salivary fistula originating from the submandibular duct. The oral surgeon performs a layered surgical closure of the fistula under local anesthesia.

Billing steps:

1. Document the clinical findings, diagnostic imaging, and operative technique in the patient’s chart.
2. Submit claim using D7983, attaching clinical notes, radiographs, and intraoral photos.
3. Include a narrative describing the cause (post-extraction complication), the necessity of closure, and the expected outcome.
4. Follow up with the payer for pre-authorization status and respond promptly to any requests for additional information.

This approach ensures the claim is supported by robust documentation and increases the likelihood of successful reimbursement.