What type of graft material is used in D3428?

D3428 involves the use of non-autogenous graft material, which is not sourced from the patient's own body.

Can D3428 be used for multiple teeth?

D3428 is billed per tooth, per site. If multiple teeth require grafting, each site should be documented and billed separately.

What is the difference between D3428 and D3426?

D3428 is specifically for bone grafts in conjunction with periradicular surgery, whereas D3426 refers to a surgical repair of a root perforation.

Are there any contraindications for using D3428?

Contraindications may include insufficient remaining tooth structure or systemic health conditions that contraindicate surgery. Always assess patient-specific factors.

D3428

Bone Graft with Periradicular Surgery - CDT Code Guide

Endodontics/Apicoectomy/Periradicular Services

Overview

CDT code D3428 refers to a bone graft procedure performed in conjunction with periradicular surgery, specifically for a single tooth site. This procedure is typically indicated when there is a need to regenerate bone in the area surrounding the root of a tooth, often following an apicoectomy or similar endodontic surgery. The graft material used is non-autogenous, meaning it is not harvested from the patient's own body. This procedure is crucial for ensuring the stability and health of the tooth after surgical intervention, particularly in cases where bone loss has occurred due to infection or trauma.

When to Use This Code

When performing an apicoectomy and there is significant bone loss around the tooth root.
In cases where periradicular surgery is necessary due to chronic infection and bone regeneration is required.
When a previous endodontic treatment has failed, and bone support needs to be restored.
During periradicular surgery for teeth with cysts or other pathological lesions affecting bone structure.
In conjunction with endodontic surgery for teeth with complex root structures requiring additional support.

Documentation Requirements

Detailed clinical notes describing the necessity of the bone graft.
Radiographic evidence showing bone loss or pathology necessitating the graft.
Description of the graft material used, including type and source.
Pre- and post-operative radiographs to document the surgical site.
Patient consent forms specifically acknowledging the use of non-autogenous graft material.

Billing Considerations

When billing for D3428, ensure that the procedure is not performed more frequently than necessary, as insurance may have limitations on the frequency of bone grafts. Use appropriate modifiers if the procedure is part of a larger treatment plan. Verify with the patient's insurance provider for coverage details, as some plans may require pre-authorization for bone graft procedures.

Related CDT Codes

D3426 D3427 D3430 D3410 D3310

Frequently Asked Questions

Coverage for D3428 varies by insurance plan. It's important to verify with the patient's provider and obtain any necessary pre-authorizations.

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