D7560Maxillary Sinusotomy for Removal of Tooth Fragment or Foreign Body

What This Code Covers

D7560 covers maxillary sinusotomy for removal of tooth fragment or foreign body. This oral surgery procedure is performed to address pathology, trauma, or other conditions in the oral and maxillofacial region. Documentation should include the diagnosis, procedure details, and any specimens submitted.

Billing Guide

Bill this code when:

• The surgical procedure described by D7560 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 D7540 (Removal of reaction producing foreign bodies, musc...)

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.