Is frenuloplasty covered by insurance?

Coverage varies by insurance plan. It is often covered when deemed medically necessary, but prior authorization may be required.

How long is the recovery period after a frenuloplasty?

Recovery typically takes one to two weeks, during which patients should follow post-operative care instructions to ensure proper healing.

Can frenuloplasty be performed on children?

Yes, frenuloplasty is commonly performed on children, especially if the frenum is causing speech or feeding issues.

What are the risks associated with frenuloplasty?

Risks may include bleeding, infection, and scarring, but these are minimized with proper surgical technique and post-operative care.

D7963

Frenuloplasty - CDT Code Guide

Oral & Maxillofacial Surgery/Other Repair Procedures

Overview

CDT code D7963 refers to the frenuloplasty procedure, which involves the excision of a frenum along with the excision or repositioning of aberrant muscle. This procedure often includes a z-plasty or other local flap closure to ensure optimal healing and function. Frenuloplasty is typically performed to address issues such as restricted tongue movement (ankyloglossia) or to improve oral function and aesthetics. It is a common procedure in oral and maxillofacial surgery, especially in cases where the frenum is causing speech difficulties, gum recession, or orthodontic problems. Dental professionals may recommend this procedure for both children and adults, depending on the clinical presentation and the impact on oral health.

When to Use This Code

When a patient presents with ankyloglossia (tongue-tie) affecting speech or feeding.
In cases where the frenum is contributing to gum recession or periodontal issues.
When orthodontic treatment requires the removal or repositioning of the frenum for better outcomes.
To alleviate discomfort or functional issues caused by a tight or abnormal frenum attachment.
In preparation for prosthetic appliances where frenum interference is anticipated.

Documentation Requirements

Detailed clinical notes describing the necessity of the procedure.
Pre-operative and post-operative photographs, if applicable.
Patient's informed consent for the procedure.
Description of the surgical technique used, including z-plasty or flap closure.
Post-operative care instructions provided to the patient.

Billing Considerations

When billing for D7963, it is important to consider any frequency limitations set by the patient's insurance. Common modifiers may include those indicating bilateral procedures or additional complexity. Ensure that the procedure is documented thoroughly to support medical necessity, as some insurance plans may require prior authorization.

Related CDT Codes

D7960 D7971 D0150 D0180

Frequently Asked Questions

Frenectomy involves the simple removal of the frenum, while frenuloplasty includes repositioning of muscle and flap closure for more complex cases.

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