Overview of CPT Code 21047: Removal of impacted tooth, partial bony

Overview of CPT Code 21047: Removal of impacted tooth, partial bony

CPT Code 21047 refers to the surgical removal of an impacted tooth that is partially covered by bone. This procedure is typically performed when a tooth, often a wisdom tooth, fails to emerge properly and causes pain or other dental issues.

When CPT Code 21047 is Used?

This code is applicable in various clinical scenarios, including:

• Presence of a partially bony impacted tooth causing pain or discomfort.
• Infection or inflammation around the impacted tooth.
• Cysts or tumors associated with the impacted tooth.
• Preparation for orthodontic treatment requiring tooth removal.

Symptoms Indicating This Procedure

Patients may report several symptoms that indicate the need for this procedure, including:

• Severe pain in the jaw or surrounding areas.
• Swelling and tenderness in the gums.
• Difficulty opening the mouth.
• Bad breath or an unpleasant taste in the mouth.
• Infection signs such as fever or pus discharge.

Causes and Risk Factors

Several factors can contribute to the development of impacted teeth, including:

• Genetic predisposition to dental crowding.
• Jaw size that is too small to accommodate all teeth.
• Early loss of primary teeth leading to misalignment.
• Poor oral hygiene resulting in gum disease.

Diagnostic Tests Before Procedure

Before proceeding with the surgery, several diagnostic tests may be conducted:

• Panoramic X-rays to assess the position of the impacted tooth.
• CT scans for detailed imaging of the jaw and surrounding structures.
• Clinical examination to evaluate symptoms and oral health.

Procedure Description

The procedure for removing a partially bony impacted tooth generally follows these steps:

• Administer local anesthesia to numb the area around the tooth.
• Make an incision in the gum tissue to expose the tooth and bone.
• Remove any bone covering the tooth if necessary.
• Extract the impacted tooth carefully.
• Clean the extraction site and close the incision with sutures.

Preparation for the Procedure

Patients should follow these steps to prepare for the surgery:

• Consult with the dentist about medications and health history.
• Avoid eating or drinking for several hours before the procedure.
• Arrange for transportation home post-surgery due to sedation.
• Follow any specific instructions provided by the dental team.

Recovery and Aftercare

Post-operative recovery typically involves the following:

• Rest for the first 24 hours after the procedure.
• Apply ice packs to reduce swelling.
• Take prescribed pain medications as directed.
• Avoid strenuous activities for a few days.
• Follow up with the dentist for suture removal if necessary.

Possible Complications

While generally safe, this procedure may carry some risks, including:

• Infection at the extraction site.
• Excessive bleeding.
• Nerve damage leading to numbness or tingling.
• Dry socket, a painful condition that can occur after tooth extraction.

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Post-Procedure Follow-Up

Follow-up care is essential for monitoring recovery:

• Schedule a follow-up appointment within a week after surgery.
• Contact the dentist if unusual symptoms occur, such as severe pain or swelling.
• Discuss any concerns regarding healing or oral hygiene.

Alternative Treatments

In some cases, non-surgical options may be considered:

• Monitoring the impacted tooth if asymptomatic.
• Antibiotics to treat infections without extraction.
• Orthodontic treatment to create space for the tooth to emerge.

Home Care Tips

To aid recovery, patients should consider the following tips:

• Maintain good oral hygiene, avoiding the extraction site initially.
• Eat soft foods and stay hydrated.
• Avoid using straws to prevent dislodging the blood clot.
• Follow all post-operative care instructions from the dentist.

Patient Education & Prevention

To prevent future issues, patients should be aware of:

• Regular dental check-ups to monitor tooth development.
• Maintaining good oral hygiene practices.
• Addressing dental crowding early with orthodontic evaluation.

Billing and Coding Information

CPT Code: 21047

Category: Surgical Procedures

Common Modifiers:

• -50
• -RT
• -LT

Average Cost and Insurance Coverage

The cost of this procedure can vary widely:

• Average cost ranges from $300 to $800.
• Insurance may cover a portion of the procedure depending on the plan.
• Pre-authorization may be required for coverage.

Related CPT Codes

• 21046 - Radiologic evaluation of temporomandibular joint
• 21045 - Radiologic guidance for needle placement in the jaw

References and Sources

• American Dental Association
• Mayo Clinic - Wisdom Teeth Removal
• WebMD - Impacted Wisdom Teeth