Periodontal diseases need to be treated on time to prevent any infection. If non-surgical treatment options fail, dentists may recommend surgical periodontic procedures to prevent future gum damage, remove bacteria from beneath the gums, and reshape the bones that support the teeth. Periodontal surgery comprises several procedures such as gingival flap surgery, mucogingival surgery, and osseous surgery. Dental practices can report such procedures on insurance claims using specific CDT and ICD-10 codes. Consider partnering with a professional dental billing company that can provide support in submitting clean dental claims.

CDT Codes for Surgical Periodontic Procedures

Gingivectomy

Gingivectomy refers to the surgical removal of gingival or gum tissue. The procedure is mainly done to treat gingivitis and for cosmetic purposes. The surgery involves removing a portion of the gums around a tooth or teeth, which can lengthen the height or width of a tooth or a section of teeth. 

  • D4210 Gingivectomy or gingivoplasty – four or more contiguous teeth or tooth bounded spaces per quadrant
  • D4211 Gingivectomy or gingivoplasty –one to three contiguous teeth or tooth bounded spaces per quadrant
  • D4212 Gingivectomy or Gingivoplasty to allow access to restorative procedure, per tooth
  • D4240 gingival flap procedure, including root planing – four or more contiguous teeth or tooth bounded spaces per quadrant
  • D4241 gingival flap procedure, including root planing – one to three contiguous teeth or tooth bounded spaces per quadrant
  • D4346 scaling in presence of generalized moderate or severe gingival inflammation- full mouth, after oral evaluation
  • D4921 gingival irrigation- per quadrant
  • D7971 excision of per coronal gingival

Dental Crown Lengthening 

For better oral hygiene and comfort, dental crowns need to be properly fixed. A dental crown lengthening procedure helps correct excess gum tissue covering the teeth. The procedure is performed by recontouring gum tissue or bone, which exposes more of a tooth’s surface for a crown.

  • D4249 Clinical crown lengthening – hard tissue 

Osseous Surgery 

This surgery is performed to manage the destruction caused by periodontal gum disease. Subtypes of osseous surgery include the bone reshaping or resectioning procedures and bone stimulative procedures. While osteotomy can reshape bones, osteotomy can correct bone defects and create normal bone contours. 

  • D4260 Osseous surgery (including flap entry and closure) – four or more contiguous teeth or tooth bounded spaces per quadrant 
  • D4261 Osseous surgery (including flap entry and closure) – one to three contiguous teeth or tooth bounded spaces per quadrant 

Mesial/Distal Wedge

This surgical procedure is done following the extraction of a wisdom tooth.  It helps to remove the additional tissue that is covering a portion of the back teeth in the gap left by the wisdom tooth. This surgery involves numbing the area using local anaesthesia and removing a small wedge of tissue and suturing the surgical wounds with stitches.

  • D4274 Mesial/distal wedge procedure, a single tooth (when not performed in conjunction with surgical procedures in the same anatomical area) 
  • D4999 Unspecified periodontal procedure, by a report

Anatomical Crown exposure

Anatomical crown exposure is recommended for uneven gum lines and for teeth appearing too short. Here, the excess gum and tissue are removed and the gum line is then sculpted to create a correct proportion between gum tissue and tooth surface.

  • D4230 Anatomical Crown Exposure four or more contiguous teeth
  • D4231 Anatomical Crown Exposure one to three contiguous teeth
  • D4268 Surgical Revision Procedure per tooth

Regeneration

During the regeneration periodontal surgical procedure, the periodontist folds back the gum tissue to eliminate bacteria. It helps in completely restoring the lost tissues.  Even after the procedure, there are chances for epithelial, gingival connective tissue or bone to grow along the root surface.

  • D4265 Biologic materials to aid in soft and osseous tissue regeneration

Soft Tissue Grafting

A gum graft is recommended to protect the teeth from the damaging effects of gum recession or to improve the appearance of the smile. Three different types of gum tissue grafts are connective-tissue grafts, free gingival grafts, and Pedicle grafts.

  • D4270 Pedicle soft tissue graft procedure

Related ICD-10 codes

  • C03 Malignant neoplasm of gum
  • C03.0 Malignant neoplasm of upper gum
  • C03.1 Malignant neoplasm of lower gum
  • C03.9 Malignant neoplasm of gum, unspecified
  • D00.00 Carcinoma in situ of the oral cavity, unspecified site
  • D10.39 Benign neoplasm of other parts of the mouth
  • K05 Gingivitis and periodontal diseases
  • K05.0 Acute gingivitis
  • K05.1 Chronic gingivitis
  • K05.2 Aggressive periodontitis
  • K05.3 Chronic periodontitis
  • K05.4 Periodontosis
  • K05.5 Other periodontal diseases
  • K05.6 Periodontal disease, unspecified
  • K06 Other disorders of gingiva and edentulous alveolar ridge
  • K06.0 Gingival recession
  • K06.1 Gingival enlargement
  • K06.2 Gingival and edentulous alveolar ridge lesions associated with trauma
  • K06.3 Horizontal alveolar bone loss
  • K06.8 Other specified disorders of gingiva and edentulous alveolar ridge
  • K06.9 Disorder of gingiva and edentulous alveolar ridge, unspecified

Choosing the right dental or diagnosis codes for these periodontal surgeries require good knowledge of the changing coding and billing standards. Professional dental billing companies can take care of the time-consuming dental insurance eligibility verification tasks, and thus ensure the smooth flow of revenue for the services provided.

Also Read:
What are the Dental Codes for Gingivectomy?
Documenting and Coding Periodontitis – Know the ICD-10 Codes
Bundling And Down coding Issues in Dental Billing and How to Address Them
ICD-10 and CDT Dental Codes and Their Eligibility Verification