Bone - Aetna Dental

Medical in Nature Oral Surgery Effective 01/01/2023

CDT Code D7270

D7284

Description (CDT code)

Tooth reimplantation and/or stabilization of accidentally evulsed or displaced tooth

Excisional biopsy of minor salivary glands

CPT Code 21140

40808

Description (CPT Code)

Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)

RequiresPrecert / Review by OMFS PM

Biopsy, vestibule of mouth

D7285

Biopsy of oral tissue (hard)

D7286

Biopsy of oral tissue (soft)

20220 20240 20245 20200 20205 40490 40808 41100 41105 41108 42100 42800

Biopsy, muscle; superficial

Biopsy, bone,excisional; superficial

Biopsy, bone, excisional; deep

Biopsy, muscle; superficial

Biopsy, muscle; deep

Biopsy of lip

Biopsy, vestibule of mouth

Biopsy of tongue, anterior two-thirds

Biopsy of tongue, Posterior one-third

Biopsy floor of mouth

Biopsy of palate, uvula

Biopsy of oropharynx

D7287

Cytology sample 88104

Cytopathology, fluids,

X

collection

washings or brushings,

except cervical or

vaginal; smears with

interpretation

D7288

Brush biopsytransepithelial

88112

Cytopathology, selective cellular enhancement

sample collection

technique with interpretation (e.g. Liquid

based slide preparation

method), except cervical

or vaginal

D7295

Harvest ofbone for 21215, 21210 use in autogenous - includes

grafting procedures obtaining the graft, in which

case this code would

not be covered 20900 - bone graft any

donor area

D7296

Corticotomy - one to 21198-52

Osteotomy, mandible,

X

three teeth or tooth

segmental;

spaces, per quadrant

D7297

Corticotomy ? four or 21206-52

Osteotomy, maxilla,

X

more teeth or tooth

segmental (eg, Wassmund

spaces, per quadrant

or Schuchard)

D7410 D7411

Excision of benign 21015 lesion up to 1.25 cm

Excision ofbenign lesion greater than 1.25 cm

21030

Radical resection of tumor (e.g., malignant

neoplasm); soft tissue of face or scalp Excision of benign tumor

or cyst of maxilla or zygoma by enucleation and curettage

21040

D7412 D7413 D7414

Excision of benign 41827 lesion, complicated

Excision of

21034

malignant lesion up

to 1.25 cm

21044

Excision of malignant lesion

21034

Excision of benign tumor or cyst of mandible, by enucleation and curettage

Excision of lesion or tumor, dentoalveolar structures, withcomplex repair

Excision ofmalignant tumor of maxilla or zygoma

Excision of malignant tumor of mandible

Excision of malignant

D7415

greater than 1.25

cm

21044

Excision of malignant lesion,

complicated

21034

21044 21045

tumor of maxilla or zygoma Excision ofmalignant tumor of mandible Excision of malignant tumor of maxilla or

zygoma Excision of malignant

tumor of mandible Excision of malignant

tumor of mandible; radical resection

D7440

Excision of malignant tumor ? lesion diameter up

to 1.25 cm

21034 21044

21045

D7441

Excision of

malignant tumor ? lesion diameter

over 1.25 cm

21034 21044

21045

D7450

Removal of benign 21030 odontogenic cyst or tumor; lesion diameter up to 1.25 cm

21040

41825

41826

41827

Excision ofmalignant tumor of maxilla or zygoma

Excision of malignant tumor of mandible;

Excision of malignant tumor ofmandible; radical resection

Excision of malignant tumor of maxilla or zygoma

Excision of malignant tumor of mandible;

Excision of malignant tumor ofmandible; radical resection

Excision of benign tumor or cyst of maxilla or zygoma by

enucleation and curettage

Review when submitted in conjunction with removal of impacted

teeth

Excision of benign cyst or tumor of mandible, by enucleation and/or

curettage

Excision of lesion or tumor, dentoalveolar structures; without

repair

Excision of lesion or tumor, dentoalveolar structures; with simple repair

Excision of lesion or tumor, dentoalveolar structures; with complex repair

D7451

Removal of benign 21030 odontogenic cyst or tumor; lesion diameter greater than 1.25 cm

21040

41825

41826

41827

D7460

Removal of benign non-odontogenic cyst or tumor; lesion diameter up

to 1.25 cm

21030

21040

41825

41826

41827

Excision of benign tumor or cyst of maxilla or zygoma by

enucleation and curettage

Review when submitted in conjunction with removal of impacted

teeth

Excision of benign cyst or tumor of mandible, by enucleation and/or

curettage

Excision of lesion or tumor, dentoalveolar structures; without repair

Excision of lesion or tumor, dentoalveolar structures; with simple repair

Excision of lesion or tumor, dentoalveolar structures; with complex repair

Excision of benign tumor or cyst of maxilla or zygoma by enucleation and

curettage

Excision of benign cyst or tumor of mandible, by enucleation and/or

curettage

Excision of lesion or tumor, dentoalveolar structures; without

repair

Excision of lesion or tumor, dentoalveolar structures; with

simple repair

Excision of lesion or tumor, dentoalveolar structures; with

complex repair

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download