D7460Removal of Benign Nonodontogenic Cyst or Tumor - Lesion Diameter Up to 1.25 Cm

What This Code Covers

D7460 covers removal of benign nonodontogenic cyst or tumor - lesion diameter up to 1.25 cm. The cyst and its lining are surgically removed. The specimen is typically submitted for pathological examination.

Billing Guide

Bill this code when:

• The surgical procedure described by D7460 is performed and documented
• The complexity and approach match the code description
• Operative notes detail the surgical technique and any complications

Do not bill this code when:

• A simple (non-surgical) extraction was performed. Use D7140
• The complexity level does not match this code description
• The procedure was performed in conjunction with another surgical code that includes it
• The procedure is better described by D7440 (Excision of malignant tumor - lesion diameter up t...)

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.