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Policy No:  52

Originally Created: 01/01/2011

Section: Oral and Maxillofacial Surgery

Last Reviewed:  01/01/2019

Last Revised:  01/01/2018

Approved: 01/01/2018

Effective:  01/01/2018

Description

Incision and drainage of abscess - intraoral soft tissue (D7510)

  • Involves incision through mucosa, including periodontal origins.

Incision and drainage of abscess - extraoral soft tissue (D7520)

  • Involves incision through skin.

Removal of foreign body from mucosa, skin or subcutaneous alveolar tissue (D7530)

Removal of reaction producing foreign bodies, musculoskeletal system (D7540)

  • May include, but is not limited to, removal of splinter, pieces of wire etc from muscle and/or bone.

Partial ostectomy/sequestrectomy for removal of non-vital bone (D7550)

  • Removal of loose or sloughed-off dead bone caused by infection or reduce blood supply.

Maxillary sinusotomy for removal of tooth fragment or foreign body (D7560)

Policy/criteria

All procedures by report with appropriate documentation.

Administrative guidelines

Apply contract benefit.

D7510, D7511, D7530-D7550 - Process to dental benefit.

D7520, D7521 and D7560 - Process to medical benefit.  Submit on medical claim form with applicable medical CPT code and diagnosis code.

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.