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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

 

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

Your use of this Dental Policy constitutes your agreement to be bound by and comply with the terms and conditions of the Dental Policy Disclaimer.