D7250Removal of Residual Tooth Roots (Cutting Procedure)

What This Code Covers

D7250 covers the surgical removal of residual tooth roots that remain in the jaw. This involves a cutting procedure (flap elevation, bone removal) to access and remove root fragments or retained root tips. Common scenarios include roots left behind from a previous extraction, roots that fractured during an attempted extraction, or root tips from teeth that broke off at the gum line. This is a surgical procedure distinct from a routine extraction.

Billing Guide

Bill this code when:

• Residual root tips or fragments are surgically removed
• A cutting procedure (flap, bone removal) is required to access the roots
• The roots are from a previously extracted or broken tooth
• The retained roots are causing symptoms or pose a risk (infection, interference with prosthesis)

Do not bill this code when:

• An erupted tooth with intact crown is extracted. Use D7140 or D7210
• Root tip removal is part of an apicoectomy on a vital tooth. Use D3410-D3427
• The root fragment is superficial and can be removed without a cutting procedure
• The root was intentionally left in situ (coronectomy) and is asymptomatic

Insurance and Denial Prevention

Key Payer Rules:

• D7250 is typically covered as a surgical oral surgery benefit
• Radiographic evidence of retained roots is required
• Some payers may question why the roots were not removed during the original extraction
• If the roots are asymptomatic and incidentally found, the payer may deny elective removal

Common Denials and How to Respond:

• Not medically necessary - Document the clinical symptoms or risk (infection, pain, interference with denture or implant placement) that justify removal.
• Should have been removed during original extraction - Explain that the roots were either left by a previous provider or fractured during the original procedure and required a separate surgical approach.
• No radiographic evidence - Submit the radiograph clearly showing the retained root fragments.