CommercialAdministrativeLow impact
04.00.05d, Extraction of Bony Impacted Teeth and Exposure of Impacted Teeth
Independence Blue Cross·PA · Dentistry, Oral & Maxillofacial Surgery·Medical Policy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued Policy 04.00.05d on 04/01/2026 to reaffirm coverage for extraction of bony impacted teeth (CPT D7230, D7240, D7241) and associated services. The policy maintains its longstanding position: extraction of impacted teeth IS covered when member benefits allow, but exposure/surgical access of unerupted teeth WITHOUT extraction (CPT D7280, D7283) remains NON-COVERED for all individuals. No substantive changes were made; this is a routine reissue to communicate the Company's continuing position.
Action Required
No immediate action required. This is a routine policy reissue with no substantive changes. Billing team should verify current billing practices align with existing guidance: (1) Ensure D7230 and D7240 extraction codes are billed only when member benefits confirm coverage (verify individual contracts, as some exclude extraction of bony impacted teeth); (2) Continue denying claims for D7280 (surgical access of unerupted tooth) and D7283 (placement of device to facilitate eruption) as these remain non-covered for all individuals under this policy; (3) Confirm that radiographic codes (70300, 70310, 70320, 70355, D0220, D0230, D0330) and E&M services are bundled with extraction procedures when medically necessary. No updates to billing software, encounter forms, or prior authorization workflows are needed.