Can D4249 be used for aesthetic purposes?

Yes, crown lengthening can be performed to improve the aesthetic appearance of the gum line.

Is pre-authorization required for D4249?

Pre-authorization requirements vary by insurance plan, so it's important to verify with the patient's provider.

How long is the recovery time after crown lengthening?

Recovery typically takes a few weeks, but complete healing can take up to three months.

Can D4249 be performed on multiple teeth at once?

Yes, crown lengthening can be performed on multiple teeth if needed, but each tooth may require separate documentation.

D4249

Clinical Crown Lengthening - CDT Code Guide

Periodontics/Surgical Services (Including Usual Postoperative Care)

Overview

CDT Code D4249 refers to the clinical crown lengthening procedure, which is essential for preparing a tooth for restorative work when there is insufficient tooth structure exposed. This surgical procedure involves the reflection of a full thickness flap and the removal of bone to alter the crown-to-root ratio, ensuring a stable foundation for restorations. It is performed in a healthy periodontal environment, distinguishing it from osseous surgery, which is used in the presence of periodontal disease. This procedure is crucial for ensuring the longevity and success of restorative treatments by providing adequate tooth structure above the gum line.

When to Use This Code

When a tooth has minimal exposed structure and requires restoration
Prior to placing a crown on a tooth with subgingival caries or fractures
To improve aesthetics by adjusting the gum line
When there is a need to increase the clinical crown height for retention
In cases where the existing crown margin is too close to the alveolar bone

Documentation Requirements

Detailed clinical notes describing the need for crown lengthening
Pre-operative radiographs showing the tooth structure and bone levels
Post-operative notes documenting the procedure and any complications
Photographic evidence of the tooth before and after the procedure
Patient consent forms acknowledging understanding of the procedure
Periodontal charting to demonstrate a healthy periodontal environment

Billing Considerations

Ensure that the procedure is not billed in conjunction with osseous surgery codes unless justified. Frequency limitations may apply based on the patient's insurance plan. Common modifiers include -22 for increased procedural services if applicable. Verify coverage with the patient's insurance, as some plans may require pre-authorization.

Related CDT Codes

D4260 D4261 D4210 D4211 D4240

Frequently Asked Questions

Crown lengthening is performed in a healthy periodontal environment to expose more tooth structure, while osseous surgery is done to treat periodontal disease.

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