When is D7560 typically billed?

D7560 is billed when a surgical incision into the maxillary sinus is necessary to remove displaced tooth fragments or foreign objects.

Is prior authorization required for D7560?

It depends on the patient's insurance plan. It's advisable to check with the insurer for any pre-authorization requirements.

What documentation is needed for insurance claims?

Comprehensive clinical notes, radiographic evidence, and detailed surgical reports are essential for insurance claims.

D7560

Maxillary Sinusotomy - CDT Code Guide

Q: Can D7560 be used for any sinus surgery?

No, D7560 specifically refers to sinusotomy for the removal of tooth fragments or foreign bodies, not for other sinus surgeries.

Oral & Maxillofacial Surgery/Surgical Incision

Overview

CDT Code D7560 refers to the procedure of maxillary sinusotomy for the removal of tooth fragments or foreign bodies. This surgical procedure is typically performed by an oral and maxillofacial surgeon. It involves creating an incision into the maxillary sinus to access and remove tooth fragments or other foreign materials that may have been displaced into the sinus cavity. This procedure is crucial when tooth fragments migrate into the sinus during dental extractions or due to trauma, which can lead to sinus infections or other complications. Understanding this code is essential for dental professionals to ensure accurate billing and patient care.

When to Use This Code

When a tooth fragment is displaced into the maxillary sinus during extraction.
To remove foreign bodies from the maxillary sinus that are causing infection or discomfort.
In cases where sinusitis is suspected to be caused by dental fragments.
When imaging confirms the presence of dental material in the sinus cavity.
During surgical planning for complex oral and maxillofacial procedures.

Documentation Requirements

Detailed clinical notes describing the need for the sinusotomy.
Radiographic evidence showing the presence of tooth fragments or foreign bodies.
Pre-operative and post-operative diagnosis.
Surgeon's report detailing the procedure performed.
Patient consent forms acknowledging understanding of the procedure.
Insurance pre-authorization if required by the patient's plan.

Billing Considerations

Ensure that the procedure is medically necessary and well-documented. Check for any frequency limitations imposed by the insurance provider. Common modifiers may include -22 for increased procedural services if applicable. Verify coverage with the patient's insurance as some plans may require prior authorization.

Related CDT Codes

D7210 D7230 D7250 D7471 D7951

Frequently Asked Questions

A maxillary sinusotomy is a surgical procedure to access the maxillary sinus, often to remove tooth fragments or foreign bodies.

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