D3230Pulpal Therapy (Resorbable Filling) - Anterior, Primary Tooth (Excluding Final Restoration)

What This Code Covers

D3230 covers complete removal of the pulp tissue from an anterior (front) primary tooth and filling of the canals with a resorbable material (such as zinc oxide eugenol paste). The resorbable filling is designed to dissolve as the primary tooth root resorbs naturally, allowing the permanent tooth to erupt normally. This is essentially a root canal on a baby front tooth. The final restoration is billed separately.

Billing Guide

Bill this code when:

• A pulpectomy (complete pulp removal) is performed on an anterior primary tooth
• The canals are filled with a resorbable material
• The tooth is a primary incisor or canine (A-E, F-J or equivalent)
• The pulp is necrotic or irreversibly inflamed, and a pulpotomy is insufficient

Do not bill this code when:

• The tooth is a posterior primary tooth. Use D3240
• Only a pulpotomy is performed (coronal pulp removal only). Use D3220
• The tooth is permanent. Use D3310 for anterior permanent root canal
• The tooth should be extracted rather than treated

Insurance and Denial Prevention

Key Payer Rules:

• D3230 is covered by most pediatric dental plans and Medicaid programs
• The tooth must be a primary anterior tooth (incisors, canines)
• Some payers require documentation that extraction was not the better option
• The resorbable filling material distinguishes this from permanent root canal therapy

Common Denials and How to Respond:

• Tooth should be extracted - Document the importance of maintaining the primary tooth for space, esthetics, speech, and function. Include the expected exfoliation date.
• Wrong tooth type - Verify the tooth letter. If the tooth is posterior, resubmit under D3240. If permanent, use D3310.
• Missing radiograph - Submit the pre-operative radiograph showing pulpal or periapical pathology.