Excision of Hyperplastic Tissue - CDT Code Guide
Overview
CDT code D7970 refers to the excision of hyperplastic tissue per arch, a procedure typically performed in the field of oral and maxillofacial surgery. This procedure involves the surgical removal of excessive tissue growth, often resulting from chronic irritation or inflammation in the oral cavity. Hyperplastic tissue can cause discomfort, impede oral hygiene, or interfere with prosthetic appliances, making its removal necessary for maintaining oral health. Dental professionals may encounter hyperplastic tissue in patients with ill-fitting dentures, chronic irritation from orthodontic appliances, or as a response to certain medications. The procedure is generally performed under local anesthesia, and the excised tissue may be sent for histopathological examination to rule out any underlying pathology.
When to Use This Code
- When a patient presents with excessive tissue growth due to ill-fitting dentures.
- In cases where hyperplastic tissue is causing discomfort or impeding oral hygiene.
- When hyperplastic tissue interferes with the fit or function of prosthetic appliances.
- For patients with chronic irritation from orthodontic appliances leading to tissue overgrowth.
- To remove tissue growth suspected to be a response to certain medications.
Documentation Requirements
- Detailed clinical notes describing the hyperplastic tissue and its impact on oral health.
- Pre-operative photographs or imaging showing the extent of tissue overgrowth.
- A clear treatment plan outlining the need for excision and expected outcomes.
- Informed consent from the patient, detailing the procedure and potential risks.
- Post-operative notes including the condition of the site and any complications.
- Pathology report if tissue is sent for histological examination.
Billing Considerations
When billing for D7970, ensure that the procedure is documented thoroughly to justify medical necessity. This code may be subject to frequency limitations, particularly if related to prosthetic adjustments. Common modifiers include those indicating bilateral procedures or unusual circumstances. Insurance coverage may vary, so pre-authorization is recommended to confirm benefits and patient responsibility.
Related CDT Codes
Frequently Asked Questions
Coverage for D7970 varies by insurance plan. It's advisable to obtain pre-authorization to confirm coverage and patient responsibility.
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