Is pre-authorization required for D7996?

Yes, pre-authorization is often required as this procedure can be complex and costly, depending on the patient's insurance plan.

Can D7996 be used for alveolar ridge augmentation?

No, D7996 specifically excludes alveolar ridge augmentation. Other codes should be used for procedures involving the alveolar ridge.

What documentation is essential for billing D7996?

Essential documentation includes a detailed surgical report, imaging, and a clear indication of the need for mandibular augmentation.

Are there any common modifiers used with D7996?

Modifiers indicating bilateral procedures or additional complexity may be used, depending on the specifics of the surgery.

D7996

Implant-Mandible Augmentation - CDT Code Guide

Oral & Maxillofacial Surgery/Other Repair Procedures

Overview

CDT code D7996 refers to the surgical procedure involving the placement of an implant in the mandible for augmentation purposes, excluding the alveolar ridge. This procedure is typically performed by oral and maxillofacial surgeons to enhance the structural integrity of the mandible, often in preparation for further dental prosthetics or to correct deformities. The procedure involves the strategic placement of implants to support the jaw structure, which can be crucial for patients with congenital defects, trauma, or significant bone loss. A detailed report is required to document the specifics of the procedure, as it varies significantly based on the patient's unique anatomical needs.

When to Use This Code

When a patient requires mandibular augmentation due to congenital defects.
In cases of significant mandibular bone loss impacting oral function.
To prepare the mandible for future dental prosthetics.
Following trauma that has compromised mandibular integrity.
As part of reconstructive surgery post-tumor removal.

Documentation Requirements

Detailed surgical report outlining the procedure.
Pre-operative and post-operative imaging to document the need and outcome.
Patient's medical history and indication for augmentation.
Description of implant type and placement location.
Surgeon's notes on the surgical technique used.

Billing Considerations

When billing for D7996, ensure that the procedure is not confused with alveolar ridge augmentation, as this code specifically excludes it. Check with the patient's insurance for coverage details, as this type of surgery may require pre-authorization. Common modifiers might include those indicating bilateral procedures or additional complexity. Frequency limitations may apply, particularly if related to preparatory work for prosthetics.

Related CDT Codes

D6010 D7950 D7953 D7997 D7999

Frequently Asked Questions

D7996 is used for mandibular implant procedures aimed at augmenting the jaw structure, excluding the alveolar ridge, often for reconstructive purposes.

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