Code Tip: D4249 Crown Lengthening-Hard Tissue

D4249 Crown Lengthening-Hard tissue is performed on a tooth with healthy periodontium (no perio disease). The procedure, to be considered a covered benefit, must follow the code descriptor carefully within the clinical documentation. Such as a “full-thickness flap reflected, and bone removed to expose more tooth structure to alter crown to root ratio.”   D4249 is not a “soft tissue” code and is a surgical type procedure that most payers look for a period of time to heal between the crown lengthening (six weeks) and the crown prep or they consider it part of the crown preparation procedure.

 There are other procedures performed on a tooth/teeth that are billed out by offices as crown lengthening such as D4214 or D42309—soft tissue crown lengthening codes—these are usually considered part of the crown prep code and are not paid separately. However, in order to be considered as a separate procedure, the narrative must state the time involved, medication, patient management issues and details of the procedures that make it unique from the standard crown prep. 

Dental Billing Tips and News for Pros; Edition #144