Is D4230 covered by most dental insurance plans?

Coverage varies by plan, so it's important to verify with the patient's insurance provider. Some plans may require prior authorization.

What are the post-operative care considerations for D4230?

Post-operative care includes monitoring for healing, managing discomfort, and ensuring the patient follows proper oral hygiene practices to prevent infection.

How does D4230 differ from other gingival procedures?

D4230 specifically involves the removal of both gingival tissue and supporting bone in a periodontally healthy area, unlike other procedures that may focus solely on soft tissue.

D4230

Anatomical Crown Exposure - CDT Code Guide

Q: Can D4230 be performed in conjunction with other periodontal procedures?

Yes, but it should not be performed in the same quadrant as other periodontal surgeries on the same day. Use appropriate modifiers if necessary.

Periodontics/Surgical Services (Including Usual Postoperative Care)

Overview

CDT Code D4230 refers to the anatomical crown exposure procedure, specifically for four or more contiguous teeth or bounded tooth spaces per quadrant. This surgical service is performed in areas that are otherwise periodontally healthy to remove excessive gingival tissue and supporting bone, known as ostectomy. The goal is to establish an anatomically correct gingival relationship, which can be crucial for both aesthetic and functional reasons. This procedure is typically indicated when there is a need to expose more of the tooth structure for restorative purposes or to address gingival overgrowth that may impede oral hygiene or proper dental function.

When to Use This Code

When there is excessive gingival tissue that needs removal for proper tooth exposure.
In preparation for restorative dental procedures requiring more tooth structure visibility.
To correct gingival overgrowth that affects oral hygiene maintenance.
When there is a need to improve the aesthetic appearance of the gingival line.
To address functional issues caused by excessive gingival tissue.

Documentation Requirements

Detailed clinical notes describing the periodontal health of the area.
Pre-operative and post-operative photographs of the surgical site.
Radiographs showing the need for anatomical crown exposure.
A comprehensive treatment plan outlining the necessity of the procedure.
Patient consent forms acknowledging understanding of the procedure.

Billing Considerations

When billing for D4230, ensure that the procedure is not performed in conjunction with other periodontal surgeries in the same quadrant on the same day. Check for any frequency limitations imposed by the patient's insurance plan. Common modifiers such as -51 (multiple procedures) may apply if performed with other services. Verify coverage with the patient's insurance provider as some plans may require prior authorization.

Related CDT Codes

D4240 D4260 D4210 D4341 D4910

Frequently Asked Questions

The primary purpose is to remove excessive gingival tissue and supporting bone to achieve a proper gingival relationship, often for aesthetic or functional reasons.

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