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I have asked two similar questions and gotten two different answers (see below). I need to know which code is more correct for our situation. If reviewed by the Dept. of Health, I desperately need to know which code is more accurate – we are not contracted with any insurance companies, so what “they” would want us to file is irrelevant. Also, in code D4231 – the 2011-2012 CDT says, “to remove enlarged gingival tissue AND supporting bone..” What if the doctor is NOT removing bone? Is this code still accurate?In response to question ‘If the doctor trims some healthy gum tissue to give a crown or bridge more tooth to adhere to, what gingivectomy type code should we use? Thank you.’ The answer is: D4211In response to question ‘When the doctor uses an electrosurge to clean up gum tissue for the purposes of removing granulation tissue, enhancing the aesthetics of a crown and increasing impression ease/accuracy.. what periodontal oriented code would best fit this?’ The answer is: The most appropriate code based on the information provided would be D4231 (anatomical crown exposure-one to three teeth per quadrat). Please note: You should always check with carrier guidelines prior to submitting a claim

July 5, 2012 by Admin

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  • I have asked two similar questions and gotten two different answers (see below). I need to know which code is more correct for our situation. If reviewed by the Dept. of Health, I desperately need to know which code is more accurate - we are not contracted with any insurance companies, so what "they" would want us to file is irrelevant. Also, in code D4231 - the 2011-2012 CDT says, "to remove enlarged gingival tissue AND supporting bone.." What if the doctor is NOT removing bone? Is this code still accurate?In response to question 'If the doctor trims some healthy gum tissue to give a crown or bridge more tooth to adhere to, what gingivectomy type code should we use? Thank you.' The answer is: D4211In response to question 'When the doctor uses an electrosurge to clean up gum tissue for the purposes of removing granulation tissue, enhancing the aesthetics of a crown and increasing impression ease/accuracy.. what periodontal oriented code would best fit this?' The answer is: The most appropriate code based on the information provided would be D4231 (anatomical crown exposure-one to three teeth per quadrat). Please note: You should always check with carrier guidelines prior to submitting a claim

I have asked two similar questions and gotten two different answers (see below). I need to know which code is more correct for our situation. If reviewed by the Dept. of Health, I desperately need to know which code is more accurate – we are not contracted with any insurance companies, so what “they” would want us to file is irrelevant. Also, in code D4231 – the 2011-2012 CDT says, “to remove enlarged gingival tissue AND supporting bone..” What if the doctor is NOT removing bone? Is this code still accurate?In response to question ‘If the doctor trims some healthy gum tissue to give a crown or bridge more tooth to adhere to, what gingivectomy type code should we use? Thank you.’ The answer is: D4211In response to question ‘When the doctor uses an electrosurge to clean up gum tissue for the purposes of removing granulation tissue, enhancing the aesthetics of a crown and increasing impression ease/accuracy.. what periodontal oriented code would best fit this?’ The answer is: The most appropriate code based on the information provided would be D4231 (anatomical crown exposure-one to three teeth per quadrat). Please note: You should always check with carrier guidelines prior to submitting a claim

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Asked on July 5, 2012 8:19 am
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If you are removing gingiva for the purpose of giving more tooth structure for a crown the most appropriate answer is D4249 crown lengthening as this would not be considered a gingivectomy.

Crown lengthening is performed to allow a crown with little or no tooth structure exposure to the oral cavity. While gingivectomy is used to remove peridontal pockets. In your description of the procedure you are exposing the tooth for a crown to sit and look more esthetically pleaseing therefore your procedure would be crown legenthening not givgivectomy.

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Answered on July 6, 2012 8:19 am
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