Is prior authorization required for D7465?

Prior authorization requirements vary by insurance provider, so it's important to check with the patient's insurance before proceeding.

Can D7465 be used for multiple lesions in one visit?

Yes, D7465 can be used for the destruction of multiple lesions in one session, but documentation must clearly indicate each lesion treated.

What are the common methods used under D7465?

Common methods include cryotherapy, laser surgery, and electrosurgery, each chosen based on the specific clinical scenario.

How should complications be documented?

Any complications should be thoroughly documented, including the nature of the complication, treatment provided, and patient outcome.

D7465

Lesion Destruction - CDT Code Guide

Oral & Maxillofacial Surgery/Excision of Soft Tissue Lesions

Overview

CDT code D7465 refers to the destruction of lesion(s) by physical or chemical methods, such as cryotherapy, laser, or electrosurgery. This procedure is typically performed by oral and maxillofacial surgeons to remove abnormal tissue growths in the oral cavity. The process involves using advanced techniques to precisely target and eliminate lesions, minimizing damage to surrounding healthy tissue. Common scenarios include the removal of benign lesions, precancerous growths, or other abnormal tissues that could potentially develop into more serious conditions. This code is essential for accurately documenting and billing these procedures, ensuring that both patients and providers are covered appropriately.

When to Use This Code

Removal of benign oral lesions using cryotherapy
Destruction of precancerous lesions with laser surgery
Elimination of abnormal tissue growths via electrosurgery
Treatment of recurrent oral lesions that require precise removal
Management of lesions that do not respond to other treatments

Documentation Requirements

Detailed description of the lesion(s) treated
Method used for destruction (e.g., cryo, laser, electro)
Clinical justification for the procedure
Pre- and post-operative diagnosis
Patient consent and understanding of the procedure
Post-operative care instructions and follow-up plan

Billing Considerations

When billing for D7465, it is important to ensure that the procedure is medically necessary and well-documented. Frequency limitations may apply based on the patient's insurance policy, and modifiers may be needed if the procedure is part of a more extensive treatment plan. It is advisable to verify coverage with the patient's insurance provider to avoid unexpected costs.

Related CDT Codes

D7410 D7411 D7460 D7461 D7471

Frequently Asked Questions

D7465 is used for benign, precancerous, or other abnormal oral lesions that require removal by physical or chemical methods.

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