D3920Hemisection (Including Any Root Removal), not Including Root Canal Therapy

What This Code Covers

D3920 covers hemisection (including any root removal), not including root canal therapy. The procedure involves accessing the pulp chamber, removing infected or necrotic tissue, shaping the canals, and sealing them with a permanent filling material. The number of canals and tooth location determine the specific code.

Billing Guide

Bill this code when:

• The endodontic treatment described by D3920 is completed
• The tooth type matches the code description
• Pre-operative and post-operative radiographs are documented

Do not bill this code when:

• The tooth type does not match (anterior, premolar, molar)
• Only partial treatment was completed. Use D3221 for pulpal debridement
• The procedure is a retreatment. Use the appropriate D3346-D3348 retreatment code
• The procedure is better described by D3910 (Surgical procedure for isolation of tooth with rub...)

Insurance and Denial Prevention

Key Payer Rules:

• Endodontic treatment is typically covered at 50-80% as a major service
• Some payers require pre-operative radiographs for approval
• Retreatment codes have different fee schedules than initial treatment
• Surgical endodontic procedures may require prior authorization

Common Denials and How to Respond:

• Not medically necessary - Submit radiographs showing the pathology and document the diagnosis and treatment rationale.
• Should be extraction - Provide documentation of why the tooth is restorable and worth saving.
• Bundled with final root canal - If this is an interim procedure, document separate dates of service and the clinical reason for staged treatment.