D3346 - RCT Retreat (Ant)
Retreatment of previous RCT, anterior.
- Procedure Code
- D3346
- Clinical Category
- Endodontics
- Primary ICD-10 Justification
- M27.5 (Periradicular pathology associated with previous endodontic treatment)
- Reference Fee & Claim Types
- BOTH
Insurance Verification Benchmarks & Billing Guidelines
Payer policy benchmarks, pre-submission attachment requirements, and denial prevention rules for D3346.
- Frequency Limitation
- Subject to group/individual contract frequency limitations (none)
Required Claim Attachments & Pre-Submission Checklist
- Diagnostic pre-operative radiograph showing affected tooth/area
Bill When (Allowable Clinical Criteria)
- Indicated for medically and clinically necessary treatment as documented in patient's dental record.
Restrictions & Clinical Exclusions
- Benefits for techniques, e.g. ultrasonic cleaning, or instrumentation are considered to be part of the procedure and not billable to the patient.
- The fee for a root canal includes treatment, working and final fill radiographic images, and temporary restorations. Fees for radiographic images and temporary restorations in the course of endodontic treatment are not billable to the patient.
- When radiograph indicates obturation of an endodontically treated tooth has been performed without the use of a solid core material, fees for the endodontic therapy and/or restoration of the tooth are not billable to the patient.
- A diagnostic film taken to ascertain the presence of pathology is a separate benefit. The initial opening into the canal and routine postoperative visits are considered part of and included in the fee for completed endodontic treatment. Separate fees are not billable to the patient.
- Incompletely filled root canals are not a benefit. Fees for the endodontic therapy are not billable to the patient.
- Root canal therapy is not a benefit in conjunction with overdentures(D5863-D5866) and benefits are denied.
Common Claim Denial Codes & Overturn Strategies
| Denial Code | Denial Reason | Appeal & Overturn Strategy |
|---|---|---|
| CO-119 | Benefit maximum or frequency limitation exceeded for procedure | Submit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria. |
ICD-10-CM Justification & Crosswalk Mappings for D3346 (6)
Click any ICD-10-CM diagnosis code below to inspect its reverse procedure mappings and differential coding guide.
| ICD-10 Code | Diagnosis Name | Category | Primary Justification | Claim Type | Clinical Scenario |
|---|---|---|---|---|---|
| M27.5 | Periradicular pathology associated with previous endodontic treatment | Other diseases of jaws | ★ Yes (Primary) | BOTH | retreatment of previous root canal therapy – anterior indicated for Periradicular pathology associated with previous endodontic treatment |
| K08.59 | Other unsatisfactory restoration of tooth | Other disorders of teeth and supporting structures | Secondary | BOTH | retreatment of previous root canal therapy – anterior indicated for Other unsatisfactory restoration of tooth |
| M27.51 | Perforation of root canal space due to endodontic treatment | Other diseases of jaws | Secondary | BOTH | retreatment of previous root canal therapy – anterior indicated for Perforation of root canal space due to endodontic treatment |
| M27.52 | Endodontic overfill | Other diseases of jaws | Secondary | BOTH | retreatment of previous root canal therapy – anterior indicated for Endodontic overfill |
| M27.53 | Endodontic undersell | Other diseases of jaws | Secondary | BOTH | retreatment of previous root canal therapy – anterior indicated for Endodontic undersell |
| M27.59 | Other periradicular pathology associated with previous endodontic treatment | Other diseases of jaws | Secondary | BOTH | retreatment of previous root canal therapy – anterior indicated for Other periradicular pathology associated with previous endodontic treatment |
Frequently Asked Questions — D3346 (RCT Retreat (Ant))
Quick answers for dental billers and treatment coordinators submitting claims for D3346.
What ICD-10 diagnosis codes link to dental procedure D3346?▾
Common ICD-10-CM justification codes for CDT D3346 (RCT Retreat (Ant)) include: M27.5 - Periradicular pathology associated with previous endodontic treatment (Primary); K08.59 - Other unsatisfactory restoration of tooth; M27.51 - Perforation of root canal space due to endodontic treatment; M27.52 - Endodontic overfill; M27.53 - Endodontic undersell; M27.59 - Other periradicular pathology associated with previous endodontic treatment.
Can CDT code D3346 be billed to medical insurance?▾
Billing CDT D3346 (RCT Retreat (Ant)) to medical insurance depends on the underlying clinical necessity and trauma/pathology documentation. Supported claim types across linked diagnoses: BOTH.
What attachments and documentation are required for billing CDT D3346?▾
Required claim attachments for CDT D3346 (RCT Retreat (Ant)) include: Diagnostic pre-operative radiograph showing affected tooth/area.
What is the insurance frequency limitation for CDT D3346?▾
Standard commercial insurance frequency for D3346: Subject to group/individual contract frequency limitations (none).
What are common insurance denial reasons and appeal tips for CDT D3346?▾
Denial Code CO-119 (Benefit maximum or frequency limitation exceeded for procedure): Overturn appeal strategy - Submit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria.