Bone Grafts and CDT Codes*

Bone Graft 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). Membrane, if used should be reported separately."
  • This is for a graft to fill in the hole where the tooth or implant was just removed.

Bone Graft for Endo/Periradicular Defects

• D3428, Bone Graft in Conjunction With Periradicular Surgery – per tooth, single site.
• CDT descriptor: "Includes non-autogenous graft material."
• D3429, Bone Graft in Conjunction With Periradicular Surgery – each add'l contiguous tooth in same surgical site.
• CDT descriptor: "Includes non-autogenous graft material."

Bone Graft for Periodontal Defects

• D4263, Bone Replacement Graft – first site in quadrant.
  • CDT descriptor: "This procedure involves the use of grafts to stimulate periodontal regeneration when the disease process has led to a deformity of the bone. This procedure 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 delivered concurrently are documented with their own codes."
• D4264, Bone Replacement Graft – each additional site in quadrant.
  • CDT descriptor: "This procedure involves the use of grafts to stimulate periodontal regeneration when the disease process has led to a deformity of the bone. This procedure 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. This procedure is performed concurrently with one or more bone replacement grafts to document the number of sites involved."
• Note: These are not grafts in extraction sites, grafts for ridge preservation, grafts in endo/periradicular sites, grafts in implant removal sites, grafts done in implant placement sites, or grafts to enhance an edentulous sites.

Bone Graft for Periimplant Defects

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

Bone Graft When Placing Implant

• D6104, Bone Graft at Time of Implant Placement
  • Placement of a barrier membrane, or biologic materials to aid in osseous regeneration are reported separately.
  • This is for bone grafting around an implant at the same time the implant is placed.

Bone Graft for Ridge Augmentation in Edentulous Site

• D7950, Osseous, Osteoperiosteal, or Cartilage Graft of the Mandible or Maxilla - Autogenous or Nonautogenous, By Report.
  • CDT descriptor: "This code may be used for ridge augmentation or reconstruction to increase height, width and/or volume of residual alveolar ridge. It includes obtaining autograft and/or allograft material. Placement of a barrier membrane, if used, should be reported separately."
  • This is not a graft done in an extraction site or implant removal site.

Bone Graft 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. Placement of a barrier membrane if used should be reported separately."
  • This is also referred to as a 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 sinus lift.

Bone Graft 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

• D3432, Guided Tissue Regeneration - resorbable barrier, per site, in conjunction with periradicular surgery.
• 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 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 placement of biologic materials to aid in osseous regeneration. This procedure can be used for periodontal and peri-implant defects."
  • Includes membrane removal.

Biologic Materials

• D3431, Biologic Materials To Aid in Soft and Osseous Tissue Regeneration in conjunction with periradicular surgery.
• D4265, Biologic Materials To Aid in Soft and Osseous Tissue Regeneration
  • CDT descriptor: "Biologic materials may be used 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. Other separate procedures may be required concurrent to D4265 and should be reported using their own unique codes."

*Current as of CDT 2015