D4322 - Splint (Intra)

Intra-coronal splinting of teeth.

Procedure Code
D4322
Category
Periodontics

Insurance Verification Benchmarks & Billing Guidelines

Benchmark Policy Source: Delta Dental 2026

Frequency Limitation
Subject to group/individual contract frequency limitations (none)

Required Claim Attachments & Pre-Submission Checklist

  • Full-mouth periodontal charting with 6-point probing depths and bleeding points

Bill When (Allowable Clinical Criteria)

  • Indicated for medically and clinically necessary treatment as documented in patient's dental record.

Restrictions & Clinical Exclusions

  • When submitted as a standalone procedure, benefits are denied unless covered by group/individual contract. crowns to provide stabilization and additional strength.
  • The fees for Intra-coronal splints submitted in conjunction with prosthetic crowns (D2700- D2799), implant prosthetics crowns (D6058- D6067, D6082-D6085, D6086-D6088, D6094, D6097), fixed partial dentures (D6205-D6794) and implant fixed partial denture retainers (D6068-D6077, D6098, D6099, D6120-D6123, D6194, D6195) are not billable to the patient.
  • Infection control is included in the fee for the dental services provided. Separate fees are not billable to the patient.
  • For benefit purposes, local anesthesia is an integral part of the periodontal procedures being performed and additional charges are not billable to the patient.
  • Laser disinfection is a technique, not a procedure. Fees for laser disinfection are not billable to the patient.
  • Benefits for laser disinfection as a standalone procedure are denied as investigational.

Common Claim Denial Codes & Overturn Strategies

Denial CodeDenial ReasonAppeal & Overturn Strategy
CO-119Benefit maximum or frequency limitation exceeded for procedureSubmit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria.

ICD-10 Justification & Crosswalk Mappings

ICD-10 CodeDiagnosis NameCategoryPrimary JustificationClaim TypeClinical Scenario