D7251 Dental Code: Extraction of Impacted Tooth – Partial Bony

The D7251 dental code refers to the surgical removal of an impacted tooth with partial bony retention. This procedure is commonly performed on partially erupted teeth that are trapped beneath the gum and bone, requiring a more complex extraction than a simple tooth removal.

Impacted teeth, particularly third molars (wisdom teeth) and canines, often necessitate this type of extraction due to their positioning. The D7251 code is crucial for accurate dental billing and ensures proper documentation for insurance claims.

This guide provides an in-depth exploration of the D7251 procedure, including indications, surgical techniques, billing considerations, and post-operative care.

2. Understanding Impacted Teeth

Definition and Causes

An impacted tooth fails to erupt fully into the dental arch due to obstruction by bone, soft tissue, or adjacent teeth. Common causes include:

• Genetic factors (small jaw size)

• Crowding (lack of space in the dental arch)

• Abnormal tooth development (angulation issues)

Common Types of Impactions

Impacted teeth can lead to pain, infection, cysts, or damage to adjacent teeth, making extraction necessary.

3. Clinical Indications for D7251

Symptoms Requiring Extraction

• Persistent pain or swelling near the impacted tooth

• Recurrent infections (pericoronitis)

• Cyst or tumor formation around the tooth

• Orthodontic reasons (to prevent crowding)

Diagnostic Procedures

• Panoramic X-rays (OPG) – Assess tooth position

• CBCT Scan – 3D imaging for complex cases

• Clinical examination – Evaluate gum tissue and adjacent teeth

4. Step-by-Step Procedure for D7251

Pre-Operative Assessment

• Review medical history (bleeding disorders, medications)

• Obtain informed consent

• Administer local anesthesia (sometimes sedation)

Surgical Technique

1. Incision – A flap is created in the gum tissue.

2. Bone Removal – A small portion of bone is removed to access the tooth.

3. Tooth Sectioning – The tooth may be divided for easier extraction.

4. Extraction – The tooth is carefully removed.

5. Suturing – The gum is stitched back for healing.

Post-Operative Care

• Pain management (NSAIDs, prescribed analgesics)

• Antibiotics (if infection is present)

• Soft diet & avoiding strenuous activity for 48 hours

5. D7251 vs. Other Extraction Codes

D7251 is specifically for partially bony impacted teeth, distinguishing it from other extraction codes.

6. Insurance and Billing Considerations

• Coverage varies by insurance plan (some require pre-authorization).

• Documentation must include X-rays and clinical notes to justify medical necessity.

• Common denials occur if the procedure is deemed “cosmetic” rather than medically necessary.

7. Complications and Risk Management

• Dry socket (alveolar osteitis) – Prevent with proper clot care.

• Nerve injury – Risk is higher with lower wisdom teeth near the inferior alveolar nerve.

• Infection – Managed with antibiotics and proper oral hygiene.

8. Patient FAQs on D7251 Extraction

Q: How painful is a D7251 extraction?
A: Discomfort is manageable with anesthesia and post-op painkillers.

Q: How long is recovery?
A: Initial healing takes 7-10 days, full bone healing may take 3-6 months.

Q: Will insurance cover D7251?
A: Most plans cover if medically necessary—check with your provider.

9. Conclusion

The D7251 dental code is essential for documenting the surgical removal of partially bony impacted teeth. Proper diagnosis, surgical technique, and post-operative care ensure successful outcomes. Understanding insurance billing and potential complications helps both dentists and patients navigate the process effectively.

10. Additional Resources

• AAE Guidelines on Impacted Teeth (American Association of Endodontists)

• ADA Dental Claim Form Instructions (American Dental Association)