Is D4268 covered by most dental insurance plans?

Coverage varies by plan. It's essential to check with the patient's insurance provider to confirm if the procedure is covered and under what conditions.

Can D4268 be performed multiple times on the same tooth?

While it can be performed more than once if clinically necessary, frequent revisions may require additional documentation and justification for insurance purposes.

What are the common post-operative care instructions following a D4268 procedure?

Patients are typically advised to follow standard post-surgical care, including maintaining oral hygiene, avoiding certain foods, and attending follow-up appointments to monitor healing.

How does D4268 differ from other periodontal surgical codes?

D4268 specifically addresses the refinement of previous surgical outcomes, focusing on adjusting tissue contours, whereas other codes may pertain to initial surgical interventions or different periodontal treatments.

D4268

Surgical Revision Procedure - CDT Code Guide

Periodontics/Surgical Services (Including Usual Postoperative Care)

Overview

CDT code D4268 refers to a surgical revision procedure performed per tooth. This procedure is typically used to refine the results of a previous surgical intervention. It involves modifying the irregular contours of hard or soft tissue, which may require elevating a mucoperiosteal flap to access and reshape the alveolar bone. Once the necessary adjustments are made, the flaps are repositioned and sutured back into place. This procedure is crucial for ensuring optimal periodontal health and aesthetics, especially when initial surgical outcomes need enhancement. Dental professionals may encounter this procedure in cases where healing has resulted in uneven tissue contours or when further refinement is necessary for functional or cosmetic reasons.

When to Use This Code

When previous periodontal surgery results in uneven tissue contours
To improve aesthetics following initial periodontal surgery
When there is a need to access and reshape alveolar bone
In cases where soft tissue healing has led to functional issues
To address patient discomfort due to irregular tissue post-surgery

Documentation Requirements

Detailed clinical notes on the initial surgical procedure
Pre-operative and post-operative photographs
Patient consent forms specifically for the revision procedure
Radiographic evidence supporting the need for revision
Comprehensive periodontal charting before and after the procedure
Detailed operative report including flap elevation and suturing details

Billing Considerations

When billing for D4268, it's important to note any frequency limitations imposed by insurance carriers. This code may require documentation of the initial procedure and justification for the revision. Common modifiers such as -25 for significant, separately identifiable evaluation and management services may be applicable. Ensure to verify coverage with the patient's insurance provider as policies may vary.

Related CDT Codes

D4260 D4261 D4270 D4240 D4241

Frequently Asked Questions

The primary purpose is to refine and improve the results of a previous periodontal surgery, ensuring optimal tissue contours and function.

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