D3410Apicoectomy - Anterior

What This Code Covers

D3410 covers the surgical removal of the apex (root tip) of an anterior tooth along with any surrounding infected tissue (periapical pathology). After the root tip is resected, a retrograde (root-end) filling is typically placed to seal the canal from the surgical end. This procedure is performed when conventional root canal therapy or retreatment has failed or is not feasible, and the tooth is otherwise worth saving.

Billing Guide

Bill this code when:

• An apicoectomy is performed on an anterior tooth (incisors, canines)
• The root tip is surgically resected and a root-end filling is placed
• The tooth has a failed or failing root canal that cannot be resolved non-surgically
• Periapical surgery is needed to address persistent pathology

Do not bill this code when:

• The tooth is a premolar. Use D3421
• The tooth is a molar. Use D3425
• Non-surgical retreatment is performed instead. Use D3346
• The entire tooth is extracted rather than treated surgically

Insurance and Denial Prevention

Key Payer Rules:

• D3410 is typically covered as a major endodontic benefit
• Most payers require evidence that conventional root canal therapy was attempted first
• The root-end filling material is included in D3410 (not billed separately)
• Some plans require specialist referral for apicoectomy coverage

Common Denials and How to Respond:

• No prior root canal on file - Submit documentation of previous endodontic treatment. If treatment was done by another provider, include records or a radiograph showing the existing root canal fill.
• Non-surgical retreatment not attempted - Document why non-surgical retreatment was not feasible (post and core, full-coverage restoration that cannot be removed, persistent pathology after retreatment).
• Extraction recommended - Provide clinical rationale for saving the tooth, including the cost and complexity of replacement options.