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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



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.


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.


CDT - D7000-D7999


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