Oroantral Fistula Closure, Primary Closure of a Sinus Perforation

Policy No: 43
Originally Created: 03/01/1997
Section: Oral and Maxillofacial Surgery
Last Reviewed: 01/01/2019
Last Revised: 01/01/2018
Approved: 01/01/2018
Effective: 01/01/2018

Description

Oroantral fistula closure (D7260)
Excision of fistulous tract between maxillary sinus and oral cavity and closure by advancement flap.

Primary closure of a sinus perforation (D7261)
Subsequent to surgical removal of tooth, exposure of sinus requiring repair, or immediate closure of oroantral or oralnasal communication in absence of fistulus tract.

Policy/criteria

Procedure is in accordance with generally accepted standards of dental practice.

Administrative guidelines

D7260 deny procedure under dental contract; procedure is non-contiguous to a tooth and considered medical procedure CPT 30580.

D7261 is considered inclusive to tooth removal.

Codes

CDT - D7000-D7999

Disclaimer

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