Looking for Dental Bone Graft Codes (CDT Codes)?

Dental bone graft codes are used for various dental procedures. Each code corresponds to a specific situation.

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Bone Graft Code for Periodontal Defects

• D3428 / D3429: Bone graft in conjunction with periradicular surgery
• D4263 / D4264: Bone Replacement Graft
  • CDT descriptor: "This procedure involves the use of osseous autografts, osseous allografts, or non-osseous grafts to stimulate periodontal regeneration when the disease process has led to a bone deformity. It does not include flap entry and closure, wound debridement, osseous contouring, or the placement of biologic materials to aid in osseous tissue regeneration or barrier membranes. Other separate procedures may be required concurrently to D4263 and should be reported using their unique codes."
  • D4263 is for the first site in a quadrant; D4264 is for each additional site in a quadrant.
  • This is not for ridge preservation, extraction sites, or implant removal sites.
  • Do not use these codes when placing a dental implant simultaneously.
  • This is not a graft to enhance an edentulous site.

Bone Graft Code for Peri-implant Defects

• D6103: Bone Graft for Repair of Peri-implant Defect
  • Does not include flap entry and closure, or placement of a barrier membrane or biologic materials to aid in osseous regeneration.
  • This is for grafting a bone defect around an existing implant.

Bone Graft Code When Placing Implant

• D6104: Bone Graft at Time of Implant Placement
  • Report the placement of a barrier membrane or biologic materials to aid in osseous regeneration separately.
  • Use this code if bone grafting around an implant at the same time you place the dental implant.

Bone Graft Code for Ridge Preservation in Extraction Socket

• D7953: Bone Replacement Graft for Ridge Preservation
  • CDT descriptor: "Osseous autograft, allograft or non-osseous graft is placed in an extraction or implant removal site at the time of the extraction or removal to preserve ridge integrity (e.g., clinically indicated in preparation for implant reconstruction or where alveolar contour is critical to planned prosthetic reconstruction)."
  • Use this code when filling in the socket after the removal of a tooth or dental implant.
  • If you use a membrane, report that separately.

Bone Graft Code for Ridge Augmentation in Edentulous Site

• D7950: Osseous, Osteoperiosteal, or Cartilage Graft of the Mandible or Maxilla—Autogenous or Nonautogenous, By Report
  • CDT descriptor: "Use this code for ridge augmentation or reconstruction to increase height, width, and/or volume of the residual alveolar ridge. It includes obtaining autograft and/or allograft material. If you place a barrier membrane, report it separately."
  • This graft is commonly called guided bone regeneration and is done in preparation for dental implant placement.

Bone Graft Code in Sinus

• D7951: Sinus Augmentation With Bone or Bone Substitutes via a Lateral Open Approach
  • CDT descriptor: "The augmentation of the sinus cavity to increase alveolar height for reconstruction of edentulous portions of the maxilla. This procedure is performed via a lateral open approach. This includes obtaining the bone or bone substitutes. Report any placement of a barrier membrane separately."
  • This is also referred to as a lateral sinus lift.
• D7952: Sinus Augmentation via a Vertical Approach
  • CDT descriptor: "The augmentation of the sinus to increase alveolar height by vertical access through the ridge crest by raising the floor of the sinus and grafting as necessary. This includes obtaining the bone or bone substitutes."
  • This is also referred to as a vertical sinus lift.

Bone Graft Code for Congenital, Traumatic, or Surgical Defects of Facial Bones

• D7955: Repair of Maxillofacial Soft Tissue and/or Hard Tissue Defect
• D7295: Harvest of Bone for Use in Autogenous Grafting Procedures

Barrier Membranes

• D4266: Guided Tissue Regeneration—Resorbable Barrier, Per Site
  • CDT descriptor: "This procedure does not include flap entry and closure, or, when indicated, wound debridement, osseous contouring, bone replacement grafts, and the placement of biologic materials to aid in osseous regeneration. This procedure can be used for periodontal and peri-implant defects."
• D4267: Guided Tissue Regeneration—Non-Resorbable Barrier, Per Site
  • CDT descriptor: "This procedure does not include flap entry and closure, or, when indicated, wound debridement, osseous contouring, bone replacement grafts, and the placement of biologic materials to aid in osseous regeneration. This procedure can be used for periodontal and peri-implant defects."
  • Furthermore, this dental bone graft includes the removal of the membrane.

Biologic Materials

• D4265: Biologic Materials to Aid in Soft and Osseous Tissue Regeneration
  • CDT descriptor: "Use biologic materials alone or with other regenerative substrates such as bone and barrier membranes, depending upon their formulation and the presentation of the periodontal defect. This procedure does not include surgical entry and closure, wound debridement, osseous contouring, or the placement of graft materials and/or barrier membranes. If other separate procedures are performed concurrently with D4265, report them separately using their unique codes."

Fees for Dental Bone Grafting Codes

Check the Fair Health Consumer website and type in the bone graft code to get an idea of fees for your zip code. The site provides fair fees based on your area.

Understanding CDT Code D6100

During my many years of working as a chairside assistant in a progressive general dentistry practice, I witnessed advances in implant technology and techniques. Dental implant treatment options to replace missing teeth offer an excellent solution for many patients. However, it is not always successful.

When treatment is unsuccessful, implant removal might be necessary.

Once an implant is placed, the bone integrates with it, a process known as osseointegration. The patient's bone grows around the implant. The healing phase typically takes 4-6 months, though it can vary. Sometimes, the body rejects the implant, requiring removal. This article focuses on documenting this removal procedure.

Documenting the Implant Removal Procedure

A tooth extraction procedure is often incorrectly documented on a claim for implant removal. This is inaccurate as it is not the removal of a natural tooth. Train your team to avoid this coding error.

CDT codes accurately document procedures, regardless of insurance claims. Always select the CDT code that most precisely describes the performed procedure.

The proper code for implant removal is:

D6100: Implant Removal, by Report

Any CDT procedure code with "by report" requires a narrative. For D6100, include why the implant needs to be removed. Specify the reason, like peri-implantitis leading to bone loss, an allergic reaction to the implant material, or patient dissatisfaction. Include this information in a narrative attached to your claim when reporting D6100 to a dental payer. Also, include the initial placement date and a radiographic image if possible.

Other Common Procedures

It is not unusual for a bone graft to be performed at the time of implant removal. While other procedures may also be performed, bone grafting is the most common. When reporting a bone graft at the time of implant removal, use D7953. Note that the descriptor for D7953 indicates it is appropriate for a graft placed in an implant removal site at the time of removal.

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D7953: Bone Graft for Ridge Preservation – Per Site

Osseous autograft, allograft, or non-osseous graft is placed in an extraction or implant removal site at the time of extraction or removal to preserve ridge integrity (e.g., in preparation for implant reconstruction or when alveolar contour is crucial to planned prosthetic reconstruction). Report any membrane usage separately.

Codes for membranes placed in conjunction with the D7953 procedure are D4266 or D4267, depending on whether the barrier membrane is resorbable or non-resorbable.

D4266: Guided Tissue Regeneration – Resorbable Barrier, Per Site

This procedure does not include flap entry and closure, wound debridement, osseous contouring, bone replacement grafts, or biologic material placement. It applies to periodontal and peri-implant defects.

D4267: Guided Tissue Regeneration – Non-Resorbable Barrier, Per Site

This procedure likewise excludes flap entry and closure, wound debridement, osseous contouring, bone replacement grafts, and biologic material placement. It applies to periodontal and peri-implant defects and includes implant removal.

Reimbursement from Code D6100 for Your Dental Practice

For reimbursement, the dental plan must include an implant rider, providing additional benefits for dental implants and associated procedures. Not all plans include an implant rider, and coverage may vary. Document and report the procedures performed regardless of reimbursement.

Properly Educate Your Team on Dental Coding and Documentation

Train your team on the information from this article to ensure coding compliance. Proper training and documentation are key to ensuring accurate reimbursement.

You now know how to document and report implant removal, bone graft placement, and any barrier membrane usage. Navigating coding associated with implant services can be challenging. Avoid confusion and mistakes by signing up for Dental Claims Academy webinars covering all aspects of coding and documentation.

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