Audience
Zip code - drawer
County - drawer

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Policy No:  33

Originally Created: 01/01/2000

Section: Periodontics

Last Reviewed:  01/01/2019

Last Revised:  01/01/2018

Approved: 01/01/2018

Effective:  01/01/2018

Description

Apically positioned flap (D4245)

Procedure is used to preserve keratinized gingiva in conjunction with osseous resection and second stage implant procedure. Procedure may also be used to preserve keratinized/attached gingiva during surgical exposure of labially impacted teeth, and may be used during treatment of peri-implantitis.

Policy/criteria

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

Procedure is considered inclusive of D4240, D4260, D4261 or D7280.

Administrative guidelines

Process to contract benefits.

Codes

CDT - D4000-D4999 - see above

Disclaimer

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