b'FOR YOUR PRACTICEAsk the Coding CoachI submitted a claim for a crown lengthening procedure on tooth #19. Benefits were denied based on the rationale that the bone height was reduced and allowed sufficient access to perform the restorative procedure. Should a different code be used? D4249, clinical crown lengtheninghard tissue, specifically states in the descriptor that a full thickness flap must be elevated, and bone removed, which is assumed to have happened in this case. Then what needs to be determined is whether the bone loss was healthy or in the presence of disease. D4249 is used only when there is no pocketing present, and the tissue is healthy. If there is bone loss accompanied by pocketing, then the code for osseous surgery should be used (D4261) even though the treatment is primarily for placement of a restoration. In some instances, if there is no tooth adjacent to where the restoration is being placed, then D4274, mesial/distal wedge procedure, could also be used. When I am exposing an implant, is it correct toSeveral new and updated CDT codes go into effect submit both D6011, surgical access to an implanton January 1, 2021. See the updates and learn body (second stage implant surgery), and D4245,how these changes will affect your periodontal apically positioned flap? practice by going to AAP Connect Libraries It would depend on the exact procedures that you AAP Member Resources Insurance are performing. When exposing an implant, D6011Reimbursement and Third-Party Issues would be the code of choice. This could indicateADA CDT 2021 Changes. Be sure to review varying ways to expose the implant, including athis resource periodically to stay up to date on punch type exposure, a gingivectomy-type whereprocedure codes.the tissue is simply trimmed, or elevating a flap and repositioning it to expose the implant. If, however, a soft tissue defect can be prevented by apically positioning the flap to preserve the keratinized tissue that was covering the implant, then both D6011 and D4245 could be used. Remember that most third-party payers will only benefit the mostSubmit your third-party questions to insurance@inclusive procedure, which in this case would mostperio.org. Members with coding questions or likely be the apically positioned flap.difficulties with insurance claims can also contact Pam Throw at 312-573-3241 or email pamela@perio.org AAP Periospectives| 24'