How to Bill and Code for Root Canal Procedures

by | Last updated Apr 19, 2023 | Published on Apr 19, 2023 | Medical Billing, Dental Insurance Verification

Root Canal Procedures
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A root canal is a common dental procedure that treats infection at the soft center of the tooth – the pulp (which is made up of nerves, connective tissue and blood vessels). Removing injured or infected pulp is the best way to preserve the structure of the tooth. The infection at the center of a tooth is caused by bacteria that live in the mouth and invade the tooth. Billing and coding for dental procedures can be challenging. Dental practices can rely on the services of a professional dental billing company for accurate claim submission.

When is Root Canal Treatment Required?

A root canal is performed to treat an injury, inflammation or infection of the pulp. Damage to the pulp can occur due to several reasons – deep tooth decay due to an untreated cavity, a chip or crack in the tooth, multiple dental procedures performed on the same tooth, leaky fillings and damage to teeth as a result of trauma, such as a fall. The crown of the tooth can remain intact even if the pulp is dead. Removing injured or infected pulp is the best way to preserve the structure of the tooth.

Pain and swelling in the tooth and a sensation of heat in the gums are the most common symptoms of damaged pulp. Root canal treatment is necessary dental X-rays confirm that the pulp has been damaged by a bacterial infection. Other symptoms of a pulp infection include – pain when eating, drinking hot or cold food and drinks, biting or chewing; pus oozing from the affected tooth; a swollen cheek or jaw; a darker color tooth, and a loose tooth. As the infection progresses, the pulp will die, often causing the symptoms to disappear. The tooth will appear to have healed, but the infection would have actually spread through the root canal system.

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CDT Codes to Report Root Canal Procedures

As tooth infections are extremely painful and pose risks for serious complications, a root canal is considered an emergency procedure. The main goals of the treatment are to remove active decay and infection, shape the canals, fill the empty canals, and restore tooth function. The CDT codes for root canal procedures include –

  • D9110 Palliative (emergency) treatment of dental pain-minor procedure
  • D0330 Panoramic radiographic image
  • D0340 2D cephalometric radiographic image acquisition, measurement and analysis
  • D0351 3D photographic image
  • D9210 Local anesthesia not in conjunction with operative or surgical procedures
  • D3220 Therapeutic pulpotomy (excluding final restoration) – removal of pulp coronal to the dentinocemental junction and application of medicament
  • D3221 Pulpal debridement, primary and permanent teeth
  • D3222 Partial pulpotomy for apexogenesis-permanent tooth with incomplete root development
  • D3230 Pulpal therapy (resorbable filling) – anterior, primary tooth (excluding final restoration)
  • D3240 Pulpal therapy (resorbable filling) – posterior, primary tooth (excluding final restoration)
  • D4211 Gingivectomy or Gingivoplasty – one to three contiguous teeth or tooth bounded spaces per quadrant [Involves the excision of the soft tissue wall of the periodontal pocket by either an external or an internal level. It is performed to eliminate suprabony pockets after adequate initial preparation, to allow access for restorative dentistry in the presence of suprabony pockets, or to restore normal architecture when gingival enlargement or asymmetrical or unaesthetic topography is evident with normal bony configuration.
  • D4212 Gingivectomy or gingivoplasty to allow access for restorative procedure, per tooth.
  • D3310 Endodontic therapy, anterior tooth (excluding final restoration)
  • D3320 Endodontic therapy, bicuspid tooth (excluding final restoration)
  • D3330 Endontic therapy, molar (excluding final restoration)
  • D3331 Treatment of root canal obstruction; non-surgical access
  • D3332 Incomplete endodontic therapy; inoperable, unrestorable or fractured tooth
  • D3333 Internal root repair of perforation defects
  • D3346 Retreatment of previous root canal therapy-anterior
  • D3347 Retreatment of previous root canal therapy-premolar
  • D3348 Retreatment of previous root canal therapy-molar

How is a Root Canal Performed?

A root canal procedure begins with a dentist administering local anesthesia in the gums. After the area is numb, the endodontist will make a small opening in the top of the tooth to expose the infected or damaged pulp and carefully remove it. The area will be coated with a topical antibiotic to prevent reinfection. After cleaning and disinfecting the canal, the opening on the top of the tooth is filled using a temporary sealant. Oral antibiotics and pain medications such as acetaminophen (Tylenol) or ibuprofen (Advil) will be prescribed to relieve any swelling. After a few days, x-rays will be taken to confirm the infection is gone. The temporary filling will then be replaced with a permanent filling. To provide a natural appearance, the dentist may place a permanent crown on the tooth.

Most people who undergo root canal treatment enjoy the positive results for the rest of their lives. Maintaining good oral hygiene is important for long-lasting results.

Dental practices can ensure error-free reporting of CDT codes for appropriate reimbursement with the help of a dental billing company. Professional dental billing support also includes comprehensive dental eligibility verification services to verify the patient’s coverage before procedures are performed.

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Amber Darst

Amber Darst is our Solutions Manager in the Healthcare Division, Practice and RCM. With a rich background in dental services, her expertise ranges from insurance coordination to office management.

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