Is D7997 covered by insurance?

Coverage for D7997 varies by insurance plan. It's important to verify with the patient's insurance provider prior to the procedure.

What documentation is needed for billing D7997?

Ensure detailed clinical notes, patient consent, and documentation of the original provider, if known, are included.

Are there any common modifiers used with D7997?

Modifiers indicating a change in provider or special circumstances may be applicable. Verify with specific insurance guidelines.

What should be included in post-removal care instructions?

Instructions should cover oral hygiene, potential symptoms to watch for, and follow-up appointments.

D7997

Appliance Removal - CDT Code Guide

Oral & Maxillofacial Surgery/Other Repair Procedures

Overview

CDT code D7997 pertains to the removal of dental appliances, specifically when the removal is not performed by the dentist who originally placed the appliance. This procedure often involves the removal of devices such as archbars, which are typically used in the stabilization of fractured jaws. The procedure is categorized under Oral & Maxillofacial Surgery, highlighting its complexity and the expertise required. Dental professionals may encounter this scenario when a patient relocates or seeks a second opinion, necessitating the removal of the appliance by a different provider. Understanding the nuances of this code is crucial for ensuring accurate billing and patient care.

When to Use This Code

A patient requires removal of an archbar by a different dentist than the one who placed it.
A patient relocates and needs appliance removal by a new dental provider.
A patient seeks a second opinion, and the new dentist decides to remove the existing appliance.
The original dentist is unavailable, and another dentist must perform the removal.
The appliance removal is part of a broader treatment plan involving multiple specialists.

Documentation Requirements

Detailed notes on the type of appliance removed.
Documentation of the original placement provider, if known.
Clinical notes explaining the reason for removal by a different dentist.
Patient consent for the removal procedure.
Post-removal care instructions provided to the patient.
Any complications or additional procedures performed during removal.

Billing Considerations

When billing for D7997, ensure that the removal is not performed by the original placing dentist. Frequency limitations may apply, and it's important to check with the patient's insurance for coverage specifics. Common modifiers may include those indicating a change in provider. Accurate documentation is essential to avoid claim denials.

Related CDT Codes

D7996 D7998 D0150 D0180 D7999

Frequently Asked Questions

No, D7997 is specifically for removal by a different dentist than the one who placed the appliance.

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