Tissue Accession & Report - CDT Code Guide
Overview
CDT Code D0472 pertains to the accession of tissue, gross examination, preparation, and transmission of a written report. This diagnostic code is crucial for dental professionals when dealing with architecturally intact tissue obtained through invasive means. The procedure involves the collection of tissue samples, which are then examined grossly to assess any pathological conditions. A detailed written report is prepared and transmitted to guide further treatment decisions. This code is often used in oral pathology laboratories to ensure accurate diagnosis and effective patient management.
When to Use This Code
- When a biopsy is performed to diagnose oral lesions.
- During the assessment of suspicious oral tissue growths.
- For the evaluation of tissue samples obtained during oral surgery.
- When monitoring changes in previously diagnosed oral pathologies.
- In cases where a comprehensive tissue analysis is required for treatment planning.
Documentation Requirements
- Detailed patient history and clinical findings leading to the tissue accession.
- Description of the tissue sample, including size and location.
- Gross examination findings documented in the patient's record.
- A copy of the written report transmitted to the referring dentist or specialist.
- Documentation of the communication of results to the patient.
- Any follow-up recommendations based on the report findings.
Billing Considerations
When billing for D0472, ensure that the procedure is medically necessary and documented thoroughly. This code may be subject to frequency limitations based on the patient's insurance plan. Common modifiers include those indicating a repeat procedure or additional services. Verify with the patient's insurance for coverage specifics, as some plans may require pre-authorization for pathology services.
Related CDT Codes
Frequently Asked Questions
D0472 covers architecturally intact tissue samples obtained through invasive procedures, such as biopsies.
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