D7230 is the CDT code for the removal of a partially bony impacted tooth — one where part of the crown is covered by bone, requiring a mucoperiosteal flap and bone removal for delivery. It sits between the soft-tissue and completely bony impaction levels.
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 D7230 Code
Report D7230 when part of the crown of an impacted tooth is covered by bone, so the dentist raises a flap and removes bone (and often sections the tooth) to deliver it. It is a step more complex than a soft-tissue impaction because bone removal is required.
Code by what covers the crown:
- D7220 — soft tissue only; flap raised, no bone removed.
- D7230 — partially bony; part of the crown under bone, requiring bone removal.
- D7240 — completely bony; most or all of the crown under bone.
An erupted tooth needing surgical access is D7210, not an impaction code. The line between D7230 and D7240 is how much of the crown the bone covers, so the radiograph matters.
Documentation & Clinical Scenarios
Because the impaction level drives reimbursement, documentation must justify "partially bony":
- Tooth number (commonly third molars) and the indication for removal.
- A radiograph (often panoramic) showing part of the crown covered by bone — not fully encased and not soft tissue alone.
- An operative narrative documenting flap elevation, bone removal, any sectioning of the tooth, and closure.
- Symptoms or pathology — pericoronitis, cyst, crowding, recurrent infection — supporting medical necessity.
If the entire crown was encased in bone, the case is D7240; if no bone was removed, it is D7220. The note and film must match the code.
Insurance & Billing Tips
- Verify benefits first. Confirm impacted-tooth coverage, any waiting period, and the remaining annual maximum.
- Document the bone removal. D7230 requires bone removal; the narrative and radiograph are what prevent a down-code to the soft-tissue level.
- Expect imaging requirements. Many payers require a film to confirm the partially bony classification before paying.
- Bill add-ons separately. Sedation, bone grafts, and membranes are distinct codes, not part of D7230.
- Read the EOB and appeal. If down-coded to D7220, resubmit with the operative note emphasizing the bone removal.
Example Case
A 21-year-old is referred for a symptomatic lower wisdom tooth with recurrent gum infection. The panoramic film shows tooth #32 with the distal crown partly covered by bone. The dentist raises a flap, removes overlying bone, sections the tooth, delivers it, and closes the site — reported as D7230 with the film and an operative narrative documenting the bone removal and sectioning. Because the partially bony level was clearly supported, the claim is paid at the D7230 level rather than down-coded to a soft-tissue impaction.
Patients call about the procedure, not the code. DentalReception AI answers and books those calls 24/7, captures insurance details, and routes clinical/billing questions to your team. See extraction calls, or book a demo.
Frequently Asked Questions
What is the difference between D7230 and D7240?
Both are bony impactions; the difference is how much bone covers the crown. D7230 is partially bony — part of the crown is covered by bone and some bone removal is required. D7240 is completely bony — most or all of the crown is covered by bone, making the removal more involved. The pre-operative radiograph and the operative narrative establish which applies, and coding a completely bony case as partially bony (or the reverse) is a common reason for a denial or a payment adjustment.
How is D7230 different from D7220?
The dividing line is bone removal. D7220 is a soft-tissue impaction where the crown is covered only by gum tissue and a flap is raised but no bone is removed. D7230 requires removing bone because part of the crown is encased in it. If your operative note documents bone removal, the case is D7230, not D7220 — and the narrative is what supports that level when a payer reviews the claim.
Does D7230 include X-rays, sedation, or bone grafts?
No. D7230 covers the surgical removal and closure of the partially bony impacted tooth. The diagnostic radiograph, any sedation, and any socket preservation graft or membrane are separate procedures with their own CDT codes. Reporting them on the extraction line causes bundling denials, so each is billed on its own line with its own supporting documentation.
Does D7230 require pre-authorization?
Many payers recommend or require a pre-treatment estimate for impacted-tooth removal and commonly request a panoramic or periapical film to confirm the impaction class. Verify benefits, confirm any waiting period and remaining maximum, and submit the radiograph with the request. Establishing the partially bony level up front reduces the chance of a denial or a down-code to D7220 after the procedure.
Confirm the current CDT descriptor and your specific payer policies before billing — browse the full dental code library or see our insurance verification feature.