Bone Replacement Graft - CDT Code Guide
Overview
CDT Code D4264 refers to the procedure of bone replacement grafting for retained natural teeth, specifically for each additional site within a quadrant. This procedure is crucial in periodontal therapy where bone deformities have occurred due to disease. It involves using grafts to stimulate the regeneration of periodontal tissues, though it excludes flap entry and closure, wound debridement, osseous contouring, and the use of biologic materials or barrier membranes. This code is used in conjunction with other grafting procedures to accurately document the number of sites treated. It is important to note that D4264 is not applicable for edentulous spaces or extraction sites, making it specific to cases where natural teeth are retained.
When to Use This Code
- When performing additional bone grafts in a quadrant with retained natural teeth
- In cases of periodontal disease leading to bone deformities
- When documenting multiple graft sites in a single quadrant
- During periodontal regenerative procedures where additional sites require grafting
- When enhancing bone support around natural teeth affected by periodontal disease
Documentation Requirements
- Detailed periodontal charting and diagnosis
- Clinical notes specifying the number of sites grafted
- Radiographic evidence supporting the need for grafting
- Documentation of patient consent and treatment plan
- Description of materials used and procedural details
- Post-operative care instructions and follow-up plan
Billing Considerations
D4264 should be billed in conjunction with primary grafting codes to indicate additional sites treated. It is important to verify the patient's insurance coverage for periodontal procedures, as some plans may have limitations on the frequency of grafting services. Common modifiers may include those indicating quadrant or site-specific treatments. Ensure accurate documentation to avoid claim denials.
Related CDT Codes
Frequently Asked Questions
No, D4264 is not applicable for extraction sites or edentulous spaces.
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