D7471Removal of Lateral Exostosis

What This Code Covers

D7471 covers the surgical removal of a lateral exostosis, a benign bony growth on the outer (buccal or labial) surface of the jawbone. These growths can interfere with denture fit, cause tissue irritation, or create challenges for other dental procedures. The surgery involves raising a flap, removing the excess bone with surgical instruments, smoothing the area, and closing the tissue.

Billing Guide

Bill this code when:

• A lateral exostosis (bony growth on the side of the jaw) is surgically removed
• The growth interferes with prosthesis placement, function, or causes symptoms
• The surgery involves flap elevation, bone removal, and closure
• The exostosis is on the buccal (cheek-side) or labial (lip-side) surface of the jaw

Do not bill this code when:

• A palatal torus is removed. Use D7340
• Mandibular tori (lingual growths) are removed. Use D7341
• General ridge recontouring is performed without a specific exostosis. Use D7320/D7321
• The bony growth is a pathologic lesion (cyst, tumor). Use appropriate pathology codes

Insurance and Denial Prevention

Key Payer Rules:

• D7471 is typically covered when there is a functional need for removal
• Documentation of prosthetic interference or clinical symptoms strengthens the claim
• Some payers consider removal of asymptomatic exostoses elective
• The procedure is distinct from torus removal (D7340/D7341) which has separate codes

Common Denials and How to Respond:

• Cosmetic or elective - Document the functional impairment (denture cannot be fabricated, tissue ulceration, interference with oral hygiene).
• Should be D7340 or D7341 - Clarify the location. D7471 is for lateral (buccal/labial) exostoses. D7340 is palatal torus, D7341 is mandibular tori (lingual).
• Not medically necessary - Submit clinical notes and photographs showing the exostosis and its impact on function or prosthesis placement.