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Which Gingivectomy Procedure Code to Use - D4210, D4211, D4212, D4274, or D7971

A gingivectomy is the removal of gingival tissue. The following CDT codes describe gingivectomy procedures and when each CDT code should be used.

D4210 and D4211: This is one of the four periodontal therapy codes together with scaling and root planing, flap surgery, and osseous surgery. It is used when the gingivectomy is being performed to eliminate suprabony pockets or, in very limited circumstances, is benefitted when the gingivectomy is being done to restore normal gingival architecture and when accompanied by explanatory clinical notes providing a justification. A D4210 or D4211, although otherwise indicated, will be disallowed when performed on the same date or service as a crown or other restoration by the same office. These codes are NOT appropriate for non-periodontal therapy procedures.

D4212: This is a relatively new (since 2013) code which describes a gingivectomy that is performed to allow access for a restorative procedure. The fee is included in the fee for the restoration except in special circumstances by written report/clinical notes and accompanied by radiographs.

D4274: This code has recently (2017) undergone a descriptor change by the ADA and no longer includes any osseous recontouring or removal. The procedure is performed in an edentulous area adjacent to a tooth allowing removal of a tissue wedge to gain access for debridement and to reduce pocket depth. Any benefit for this procedure will be disallowed when performed in conjunction with another surgical procedure in the same area. If bone removal is indicated or performed, use D4261 instead of D4274.

D7971: This code is to be used when inflammatory or hypertrophied tissue is being removed on a partially erupted or impacted tooth (i.e. operculectomy). The fee for this procedure performed on the same date of service as another surgical procedure in the same surgical area by the same dentist/dental office is disallowed.