Can D4270 be used for all types of gingival recession?

D4270 is suitable for cases where the root is not too prominent in the arch, and there is sufficient donor tissue available.

Is pre-authorization required for D4270?

Pre-authorization requirements vary by insurance provider; it's advisable to check with the patient's plan.

How does D4270 differ from other grafting procedures?

D4270 specifically involves a pedicle flap, which is moved laterally or coronally, unlike free gingival grafts that use donor tissue from another site.

What postoperative care is typically required after a D4270 procedure?

Postoperative care includes monitoring for infection, managing discomfort, and ensuring proper healing of the graft site.

D4270

Pedicle Soft Tissue Graft - CDT Code Guide

Periodontics/Surgical Services (Including Usual Postoperative Care)

Overview

CDT Code D4270 refers to the pedicle soft tissue graft procedure, a specialized periodontal surgical service. This procedure involves raising a flap of gingiva from an edentulous ridge, adjacent teeth, or existing gingiva on a tooth. The flap is then moved laterally or coronally to replace alveolar marginal tissue or mucosa. This technique is particularly useful for covering exposed roots or eliminating gingival defects, provided the root is not excessively prominent in the dental arch. The procedure is critical in maintaining periodontal health and aesthetics, especially in cases where gingival recession has occurred.

When to Use This Code

To cover an exposed root surface due to gingival recession.
To improve the aesthetics of a patient's smile by restoring gingival tissue.
To address gingival defects adjacent to an edentulous ridge.
When there is a need to increase the zone of attached gingiva.
To prepare a site for further restorative or prosthetic procedures.

Documentation Requirements

Detailed periodontal charting and clinical notes indicating the need for the graft.
Pre-operative and post-operative photographs of the surgical site.
Patient's informed consent for the procedure.
Documentation of the surgical technique and materials used.
Post-operative care instructions provided to the patient.
Follow-up visit notes to monitor healing and outcomes.

Billing Considerations

When billing for D4270, it's important to note any frequency limitations imposed by the patient's insurance. Common modifiers may include those indicating bilateral procedures or unusual circumstances. Ensure that the procedure is not billed concurrently with other periodontal surgeries unless justified. Verify with the patient's insurance for coverage specifics, as some plans may have restrictions on periodontal surgical services.

Related CDT Codes

D4260 D4263 D4277 D4273 D4210

Frequently Asked Questions

The primary purpose is to cover exposed roots or correct gingival defects, enhancing both function and aesthetics.

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