Excision Benign Lesion - CDT Code Guide
Overview
CDT Code D7412 refers to the excision of a benign lesion in the oral cavity that is considered complicated. This procedure involves the removal of non-cancerous growths that may require extensive surgical techniques such as undermining with advancement or rotational flap closure to ensure proper healing and functionality. Typically, this code is used when lesions are large or located in areas that demand intricate surgical intervention to preserve oral structures and aesthetics. Dental professionals may encounter this scenario in cases where benign lesions interfere with oral function or pose a risk of transformation.
When to Use This Code
- When removing a large benign lesion that requires complex closure techniques.
- In cases where the lesion is located in a challenging area, necessitating advanced surgical skills.
- When the lesion's removal involves significant undermining to achieve adequate closure.
- For lesions that, if left untreated, could impact oral function or aesthetics.
- When a rotational or advancement flap is necessary to ensure proper healing.
Documentation Requirements
- Detailed clinical notes describing the lesion and its location.
- Pre-operative and post-operative photographs, if applicable.
- A thorough description of the surgical technique used, including flap design.
- Patient consent forms specific to the procedure.
- Pathology report confirming the benign nature of the lesion.
- Follow-up care instructions provided to the patient.
Billing Considerations
When billing for D7412, it's important to note that this code is typically used for more complex cases and may require justification through detailed documentation. Frequency limitations may apply depending on the patient's insurance plan. Common modifiers, such as those indicating bilateral procedures or multiple lesions, should be used as appropriate. Coordination with insurance providers is recommended to confirm coverage specifics.
Related CDT Codes
Frequently Asked Questions
A lesion excision is considered 'complicated' when it involves extensive surgical techniques such as undermining or flap closure to ensure proper healing.
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