Is a buccal labial frenectomy covered by insurance?

Coverage varies by insurance provider and plan. It's important to verify coverage with the patient's insurance before proceeding with the procedure.

How long is the recovery period after a frenectomy?

Recovery typically takes about 1 to 2 weeks. Patients may experience some discomfort and swelling, which can be managed with prescribed pain medication and proper oral hygiene.

Can a frenectomy be performed on children?

Yes, frenectomies are often performed on children, especially if the frenum is affecting speech development or causing dental issues.

What are the risks associated with a frenectomy?

Risks are minimal but can include bleeding, infection, or scarring. Proper post-operative care and following the dentist's instructions can minimize these risks.

D7961

Buccal Labial Frenectomy - CDT Code Guide

Oral & Maxillofacial Surgery/Other Repair Procedures

Overview

CDT code D7961 refers to the buccal labial frenectomy, also known as a frenulectomy. This procedure involves the surgical removal or modification of the frenum, a small fold of tissue that connects the lip to the gum in the mouth. A frenectomy is typically performed to address issues such as a gap between the front teeth, speech impediments, or difficulties with oral hygiene due to restricted lip movement. Dental professionals often recommend this procedure when the frenum is causing functional or aesthetic concerns. In clinical practice, a frenectomy can significantly improve a patient's oral function and overall dental health.

When to Use This Code

When a patient has a diastema (gap) between the upper front teeth caused by a tight frenum.
In cases where the frenum is causing speech difficulties or impediments.
When the frenum restricts lip movement, affecting oral hygiene or comfort.
To alleviate gum recession caused by a pulling frenum.
When orthodontic treatment requires removal of the frenum for better results.

Documentation Requirements

Detailed clinical notes describing the necessity of the procedure.
Pre-operative photographs showing the frenum and associated issues.
Patient consent forms acknowledging understanding of the procedure.
Post-operative care instructions provided to the patient.
Documentation of any complications or additional procedures performed.

Billing Considerations

When billing for D7961, it's important to verify the patient's insurance coverage for oral surgery procedures, as coverage can vary. This code may be subject to frequency limitations, so check with the payer for any restrictions. Common modifiers such as '-51' for multiple procedures may apply if the frenectomy is performed alongside other surgical procedures. Ensure all documentation is thorough to support the medical necessity of the procedure.

Related CDT Codes

D7960 D7280 D7210 D7220 D7230

Frequently Asked Questions

A frenectomy involves the complete removal of the frenum, while a frenotomy is a less invasive procedure that involves cutting the frenum to release tension.

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