D3220Therapeutic Pulpotomy (Excluding Final Restoration) - Removal of Pulp Coronal to the Dentinocemental Junction and Application of Medicament

What This Code Covers

D3220 covers the removal of the coronal (crown) portion of the pulp from a primary (baby) tooth, followed by placement of a medicament (such as formocresol or MTA) on the remaining vital root pulp. This is the most common pulp therapy for primary teeth with deep decay that has reached the pulp. The final restoration (typically a stainless steel crown, D2930) is billed separately.

Billing Guide

Bill this code when:

• A pulpotomy is performed on a primary tooth
• The coronal pulp is removed and medicament is placed on the remaining root pulp stumps
• The tooth will be restored with a crown or other restoration (billed separately)
• The primary tooth has a pulp exposure from deep caries

Do not bill this code when:

• The tooth is permanent. Use D3221 for therapeutic pulpotomy on a permanent tooth
• Complete pulp removal (pulpectomy) is performed. Use D3230 or D3240
• Only a pulp cap is placed without pulp removal. Use D3110 or D3120
• The primary tooth should be extracted rather than treated

Insurance and Denial Prevention

Key Payer Rules:

• D3220 is widely covered by pediatric dental plans and Medicaid for primary teeth
• Most payers allow D3220 and D2930 (stainless steel crown) on the same date
• The tooth must be primary. For permanent teeth, use D3221
• Some payers limit pulpotomy to one per tooth

Common Denials and How to Respond:

• Tooth should be extracted - Provide the expected exfoliation date and explain why preservation of the primary tooth is important for space maintenance and function.
• No radiograph on file - Submit the pre-operative radiograph showing caries involvement near the pulp.
• Wrong code for permanent tooth - If the tooth is permanent, resubmit under D3221. If the tooth is primary, clarify the tooth designation.