Is pre-authorization required for D7261?

Pre-authorization may be required depending on the patient's insurance plan, as coverage for surgical procedures can vary.

Can D7261 be billed with other surgical procedures?

Yes, D7261 can be billed with other procedures, but appropriate modifiers should be used to indicate multiple procedures.

What are the potential complications if a sinus perforation is not properly closed?

Failure to properly close a sinus perforation can lead to sinus infections, chronic sinusitis, or the development of a fistulous tract.

What documentation is essential for billing D7261?

Essential documentation includes surgical notes, radiographs, patient consent, and post-operative care instructions.

D7261

Primary Closure of Sinus Perforation - CDT Code Guide

Oral & Maxillofacial Surgery/Other Surgical Procedures

Overview

CDT code D7261 pertains to the primary closure of a sinus perforation, a procedure often necessary following the surgical removal of a tooth. This procedure is crucial when there is an exposure of the sinus that requires immediate repair, or when there is a need to close an oroantral or oralnasal communication without the presence of a fistulous tract. Typically, this situation arises in oral and maxillofacial surgery when the sinus cavity is inadvertently opened during the extraction of upper molars or other surgical interventions. The primary goal of this procedure is to prevent complications such as sinus infections or chronic sinusitis by ensuring the sinus is properly sealed.

When to Use This Code

Following the surgical extraction of an upper molar with sinus exposure
When there is an accidental perforation of the sinus during oral surgery
To close an oroantral communication immediately after tooth removal
In the absence of a fistulous tract post-extraction
To prevent potential sinus infections after oral surgery

Documentation Requirements

Detailed surgical notes describing the sinus exposure
Pre- and post-operative radiographs if applicable
Patient consent forms for the procedure
Description of the closure technique used
Post-operative care instructions provided to the patient
Any complications encountered during the procedure

Billing Considerations

When billing for D7261, it is important to note that this code is specific to the primary closure of a sinus perforation and should not be used if a fistulous tract is present. It is often billed alongside other surgical codes, and modifiers may be necessary if additional procedures are performed concurrently. Insurance coverage can vary, so pre-authorization may be required to ensure reimbursement.

Related CDT Codes

D7210 D7250 D7280 D7953 D7960

Frequently Asked Questions

D7261 should be used when there is a need for primary closure of a sinus perforation without a fistulous tract, typically following tooth extraction.

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