D7284Excisional Biopsy of Minor Salivary Gland

What This Code Covers

D7284 covers excisional biopsy of minor salivary gland. The entire lesion is removed and submitted for pathological examination. The specimen is sent to a pathology laboratory with appropriate documentation.

Billing Guide

Bill this code when:

• The biopsy procedure described by D7284 is performed
• The tissue type (hard or soft) matches the code description
• A specimen is submitted to pathology with the appropriate requisition

Do not bill this code when:

• The tissue type does not match (hard tissue vs. soft tissue)
• No specimen was actually collected or submitted for analysis
• The procedure is better coded as an excision rather than a biopsy
• The procedure is better described by D7270 (Tooth reimplantation and/or stabilization of accid...)

Insurance and Denial Prevention

Key Payer Rules:

• Surgical procedures may be covered under dental or medical insurance depending on the plan
• Impacted tooth extractions are often covered under both dental and medical plans
• Complex surgical procedures may require prior authorization
• Pathology-related procedures may be better covered under the medical benefit

Common Denials and How to Respond:

• Should be billed to medical - Some oral surgery codes are covered under medical rather than dental benefits. Check both plans.
• Not medically necessary - Submit operative notes, radiographs, and pathology reports to support the surgical indication.
• Complexity level disputed - Document the surgical approach, complications, and any bone removal or tooth sectioning performed.