Bill D7972 Fibrous tuberosity reduction twice for bilateral case?

[planisphere]

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I'm a dental student trying to refer a patient to OS who has bilateral tuberosity outgrowth (mostly soft tissue; going through combination syndrome). Patient is completely edentulous on top.

Patient asks for the price, and the procedure code is D7972, and according to ADA it is billed per quadrant (on img, Y is on "Quadrant"). I was wondering tuberosity reduction is going to be mostly bilateral, and why they bill it per quadrant. If I have to bill her x2, it's going to be pricey even for dental school.

Even my OS dept instructor wasn't even sure if the code is per quad or per arch (I found it out myself on ADA website...). Do we really bill patients the same code twice in such bilateral case?

 

[DentistRays]

Based on the CDT descriptor, D7972 is reported per quadrant, not per arch. So if both the right and left maxillary tuberosities require fibrous tuberosity reduction, it would generally be billed twice since they're considered separate quadrants.

The rationale is that each tuberosity is a separate surgical site. Even if both are treated during the same appointment, the surgeon is performing surgery in two distinct anatomic areas, each requiring its own evaluation, flap management (when indicated), reduction, contouring, and closure as needed. That's why the code is defined on a quadrant basis rather than an arch basis.

In a dental school setting tho, the patient's fee may still be reduced depending on the school's fee schedule or billing policies, but from a coding standpoint, bilateral maxillary tuberosity reductions would typically be reported as two quadrants.
Talk to your billing dept and your faculty,they might just waive the fee for the second code and charge the patient for just one.