Is removal of lateral exostosis covered by insurance?

Coverage varies by insurance plan. Pre-authorization is recommended to confirm benefits and coverage.

How long is the recovery after exostosis removal?

Recovery typically takes a few weeks, with most patients returning to normal activities within a week, depending on the extent of the surgery.

Can exostosis recur after removal?

Recurrence is rare but possible. Regular follow-ups are advised to monitor the surgical site.

What are the risks associated with this procedure?

Risks include infection, bleeding, nerve damage, or delayed healing, which are generally low with proper surgical technique.

D7471

Removal of Lateral Exostosis - CDT Code Guide

Oral & Maxillofacial Surgery/Excision of Bone Tissue

Overview

CDT code D7471 refers to the removal of lateral exostosis, which is a surgical procedure involving the excision of excess bone growth on the maxilla or mandible. This procedure is typically performed by an oral surgeon and is necessary when the exostosis causes discomfort, affects oral function, or complicates prosthetic appliance placement. Patients may experience symptoms such as pain, irritation, or difficulty with dental prosthetics, prompting the need for this intervention. Clinically, the procedure involves accessing the affected area, removing the excess bone, and ensuring the site is smooth to facilitate healing and restore normal oral function.

When to Use This Code

When a patient experiences discomfort due to bony overgrowth on the maxilla or mandible.
In preparation for denture placement where exostosis interferes with the fit.
When exostosis causes irritation or ulceration of the oral mucosa.
To facilitate orthodontic treatment where bone overgrowth impedes tooth movement.
As part of surgical planning for other oral surgeries requiring a smooth bone surface.

Documentation Requirements

Detailed clinical notes describing the location and size of the exostosis.
Pre-operative radiographs or imaging showing the extent of the bone growth.
Surgical report outlining the procedure, including anesthesia used and post-operative care.
Patient consent forms acknowledging understanding of the procedure and potential risks.
Post-operative follow-up notes documenting healing and any complications.

Billing Considerations

When billing for D7471, ensure that the procedure is medically necessary and well-documented. Frequency limitations typically do not apply, but it's crucial to verify with the patient's insurance provider. Common modifiers such as -22 for increased procedural services may be applicable if the surgery is more complex than usual. Always check for specific payer guidelines regarding pre-authorization requirements.

Related CDT Codes

D7472 D7473 D7410 D7411 D7412

Frequently Asked Questions

A lateral exostosis is a benign bony growth on the outer surface of the maxilla or mandible, often requiring removal if symptomatic.

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