D3220 is the CDT code for a therapeutic pulpotomy — the removal of the coronal (crown-portion) pulp to the dentinocemental junction and the application of a medicament, excluding the final restoration. It treats the affected pulp tissue while preserving the remaining vital root pulp, and the restoration that rebuilds the tooth is reported separately.
Informational only — confirm the official CDT descriptor and your payers' rules independently. This is general guidance, not billing, coding, or clinical advice.
When to Use the D3220 Code
Report D3220 when the dentist performs a therapeutic pulpotomy — removing the coronal pulp and placing a medicament — most commonly on primary teeth, or as an interim measure on a permanent tooth, while leaving the radicular (root) pulp intact.
Don't confuse it with a full root canal or a palliative opening. D3220 is not complete endodontic therapy: a root canal on the whole pulp system is reported as D3310 (anterior), D3320 (premolar), or D3330 (molar). A pulpotomy is also distinct from a pulpal debridement (D3221), which relieves acute pain as a separate-visit procedure. And because the final restoration is excluded, the filling or crown placed afterward is reported under its own code.
Documentation & Clinical Scenarios
The record should support the diagnosis, the procedure, and the excluded restoration:
- Tooth number and the diagnosis (e.g., reversible/irreversible pulpitis or deep caries reaching the pulp).
- Radiograph(s) supporting the pulpal condition.
- Procedure detail — removal of the coronal pulp to the dentinocemental junction and the medicament applied to the radicular pulp.
- The excluded restoration — the buildup or crown that follows, documented and billed separately.
Because D3220 explicitly excludes the final restoration, the chart should clearly separate the pulpotomy from whatever restores the tooth afterward.
Insurance & Billing Tips
- Verify benefits and tooth type. Confirm whether the plan covers pulpotomy on the tooth in question (rules often differ for primary vs. permanent teeth).
- Bill the restoration separately. D3220 never includes the filling or crown — report the restoration on its own line so neither is denied for bundling.
- Don't bill a pulpotomy as a root canal. If complete endodontic therapy is performed, the correct code is D3310/D3320/D3330, not D3220 — and vice versa.
- Distinguish from D3221. A pulpal debridement for acute pain is a different code; using the wrong one can cause a denial.
- Read the EOB. If the pulpotomy is down-coded, the radiograph and diagnosis support an appeal.
Example Case
A 6-year-old established patient has deep decay into the pulp of a primary molar but the root pulp is still vital. The dentist removes the coronal pulp, applies a medicament to the radicular pulp, and plans a stainless-steel crown to restore the tooth. The procedure is coded D3220 for the therapeutic pulpotomy, with the tooth number, diagnosis, and radiograph documented, and the crown is reported separately under its own code. Because the office verified the plan's coverage for pulpotomy on a primary tooth and billed the restoration on its own line, both claims process without a bundling denial.
Patients call about the procedure, not the code. DentalReception AI answers and books those calls 24/7, captures the symptom and urgency in the patient's words, and routes every clinical and billing question to your team. See how it handles root canal calls, or book a demo.
Frequently Asked Questions
Is a pulpotomy (D3220) the same as a root canal?
No. A therapeutic pulpotomy removes only the coronal pulp and treats the remaining vital root pulp with a medicament, whereas a root canal removes the entire pulp from the crown and the roots. Complete endodontic therapy is reported under D3310 (anterior), D3320 (premolar), or D3330 (molar), not D3220. Billing a pulpotomy as a root canal — or the reverse — is a common error that can trigger a denial.
Does D3220 include the filling or crown afterward?
No. D3220 explicitly excludes the final restoration. The buildup, filling, or crown that rebuilds the tooth after the pulpotomy is reported separately under its own restorative code. Billing them on the same line as the pulpotomy is a frequent cause of bundling denials, so the restoration should always appear on its own line with the appropriate code.
How is D3220 different from a pulpal debridement (D3221)?
Both involve the pulp, but they serve different purposes. D3220 is a therapeutic pulpotomy that removes the coronal pulp and places a medicament as treatment, while D3221 is a pulpal debridement performed to relieve acute pain, typically as a distinct procedure before definitive treatment. Using the wrong one can cause a denial, so the chart should make clear which procedure was actually performed and why.
Does D3220 require a pre-authorization?
A pre-authorization isn't always required, but verifying benefits is worthwhile because coverage rules often differ for primary versus permanent teeth. Confirming the plan covers a pulpotomy on the specific tooth — and documenting the diagnosis and a supporting radiograph — reduces the chance of a denial or down-code and provides the basis for an appeal if the claim is questioned.
Confirm the current CDT descriptor and your specific payer policies before billing — browse the full dental code library or see our insurance verification feature.