Can D4261 be billed with other periodontal procedures?

Yes, but each procedure must be documented separately and coded with its unique CDT code.

Is osseous surgery covered by dental insurance?

Coverage varies by plan; it's essential to check with the insurance provider for specific benefits and limitations.

How long is the recovery period after osseous surgery?

Recovery typically takes a few weeks, with initial healing in 1-2 weeks and full healing over several months.

D4261

Osseous Surgery - CDT Code Guide

Periodontics/Surgical Services (Including Usual Postoperative Care)

Overview

CDT code D4261 refers to osseous surgery, a periodontal procedure aimed at reshaping the alveolar bone surrounding teeth. This surgery involves the elevation of a full-thickness flap and the removal of supporting (ostectomy) or non-supporting bone (osteoplasty) to create a more physiologic bone form. Typically, this procedure is performed to treat periodontal disease where bone loss has occurred, and it is essential for improving the long-term stability of teeth. Dental professionals may perform osseous surgery on one to three contiguous teeth or tooth-bounded spaces per quadrant, ensuring that the affected area is properly treated to prevent further periodontal deterioration.

When to Use This Code

When there is significant bone loss due to periodontal disease affecting one to three teeth in a quadrant.
To reshape the alveolar bone for better periodontal health and tooth stability.
When non-surgical periodontal therapy has not been sufficient in managing periodontal disease.
To prepare the bone for future restorative or prosthetic procedures.
In cases where periodontal pockets are too deep for effective cleaning and maintenance.

Documentation Requirements

Detailed periodontal charting showing bone loss and periodontal pocket depth.
Pre-operative radiographs demonstrating the need for osseous surgery.
Clinical notes describing the procedure performed, including flap elevation and bone contouring.
Post-operative care instructions provided to the patient.
Documentation of any concurrent procedures performed with their respective codes.

Billing Considerations

Osseous surgery under code D4261 is typically subject to frequency limitations, often covered once per quadrant every 3-5 years, depending on the insurance plan. Common modifiers may include those indicating the specific quadrant treated. It's important to verify coverage with the patient's insurance provider, as periodontal procedures can vary widely in terms of coverage and patient responsibility.

Related CDT Codes

D4260 D4210 D4240 D4910

Frequently Asked Questions

D4261 is used for osseous surgery involving one to three teeth per quadrant, while D4260 is for four or more teeth per quadrant.

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