Coding Copy 4

Dental coding with Kyle: D4249—Clinical crown lengthening, hard tissue

Sept. 12, 2019
Submitting the proper code with the correct documentation is important for your practice to be reimbursed for treatment. But coding can be tricky!

Purpose: If a tooth breaks or is grossly decayed it may be difficult to restore with a crown.

A crown lengthening is performed when there is very little remaining tooth structure. The procedure involves a tissue flap, which removes bone and soft tissue to expose more tooth surface so that it may be properly restored.

Submitting the claim with x-rays is not enough to facilitate coverage and payment.

• This code should be applied only when the procedure involves removing hard tissue (bone).

 Dental insurance companies will refer to the patient plan limitations and exclusions when considering the dental claim. This procedure has a limitation of once per lifetime, per tooth.

 If reporting a restorative procedure on the same tooth and on the same day as crown lengthening, the claim will be denied for payment.

 A narrative should be included that indicates percentage of tooth structure remaining after crown lengthening.

 Pre-op and post op x-rays must always accompany the claim form, and in addition, periodontal charting should be included.

Good luck coding!