D3220 is the CDT code for a therapeutic pulpotomy, excluding the final restoration. It covers the removal of the coronal portion of the dental pulp as a therapeutic measure to address acute pulpal pain or inflammation, often performed as an emergency or interim procedure before definitive endodontic treatment. The final restoration is billed separately.
Last updated June 2026 ยท Reviewed by the PracticeAlpha billing team
Get help with D3220 claims →Use D3220 when removing the coronal pulp tissue as a therapeutic measure to relieve acute pain or manage an inflamed pulp prior to definitive treatment. This is typically an emergency or staged procedure. The radicular (root) pulp is left intact. The procedure is performed to provide immediate relief when the full root canal cannot be completed at that visit.
Common clinical scenarios: Patient presenting with acute pulpalgia requiring emergency pain relief. Tooth with symptomatic irreversible pulpitis where full root canal therapy is planned for a subsequent visit. Staged endodontic treatment due to time constraints, patient medical considerations, or treatment planning needs. Note: for primary teeth, use D3230 or D3240 instead.
Do NOT use D3220 for: Procedures where only a pulp cap is placed without tissue removal (use D3110 or D3120). Pulpotomy on primary teeth intended as a definitive treatment (use D3230 for anterior, D3240 for posterior primary teeth). Full root canal therapy completed in one visit (use D3310, D3320, or D3330 based on tooth type). Cases where the pulp is already necrotic and no vital tissue is removed.
Some payers treat the pulpotomy as part of the root canal fee when both occur within a short timeframe. If the full root canal is completed within 30 to 90 days, certain plans will deny D3220 as a duplicate or bundle it into the root canal reimbursement. Document clearly that D3220 was a distinct emergency visit, note the date and clinical urgency, and be aware of the patient's plan policy before billing.
Using D3220 for a pulpotomy on a primary tooth can result in a denial. The CDT codes D3230 and D3240 are specifically designated for pulpotomy procedures on primary teeth. Verify tooth type and apply the correct code. D3220 is appropriate for permanent teeth.
The note must establish why pulpotomy was indicated as an emergency or interim measure. "Pulpotomy performed" is not sufficient. Document the patient's chief complaint, the clinical and radiographic findings, the presence of acute inflammation, the reason the full root canal was not completed at this visit, and the plan for definitive treatment.
Some dental plans do not cover D3220 or require a specific diagnosis code or narrative. Verify coverage before treatment. If non-covered, inform the patient in writing before performing the procedure so they understand the financial responsibility.
X-ray of the affected tooth showing the extent of the lesion, pulp chamber, and root canal anatomy. Supports the clinical finding of irreversible pulpitis or acute inflammation and documents pre-operative status.
Describe the patient's chief complaint, symptoms, clinical findings, and the clinical reasoning for pulpotomy as the appropriate emergency intervention. Include vitality testing results if performed.
Note that the coronal pulp tissue was removed and the radicular pulp was left intact. Describe the appearance of the pulp tissue and any medicament placed after the procedure.
If D3220 is an interim procedure, document the planned follow-up treatment (root canal therapy, extraction, or other) and the expected timeline. This distinguishes the pulpotomy as a staged procedure rather than a standalone treatment.
D3220 excludes the final restoration. If a temporary or permanent restoration is placed at the same visit, bill the appropriate restorative code alongside D3220 and document it in the clinical record.
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Learn about our billing servicesD3220 is the CDT code for a therapeutic pulpotomy, excluding the final restoration. It covers the removal of the coronal pulp tissue as an emergency or interim therapeutic measure to relieve acute pulpal pain before definitive root canal treatment.
D3220 is used on permanent teeth. For primary teeth, use D3230 (anterior) or D3240 (posterior). Billing D3220 for a primary tooth pulpotomy can result in a denial.
No. D3220 explicitly excludes the final restoration. Bill the appropriate restorative code separately on the same claim or on the date the restoration is placed.
Common reasons: payer bundles D3220 into a subsequent root canal fee, wrong code used for a primary tooth, insufficient clinical documentation of acute presentation, or the plan classifies pulpotomy as non-covered.
Yes, but some payers will bundle the pulpotomy fee into the root canal if both occur within a short window. Document clearly that D3220 was a separate emergency visit with distinct clinical justification from the scheduled root canal appointment.
D3110 places a medicament over an exposed pulp without removing tissue. D3220 removes the entire coronal pulp tissue. D3220 is a more extensive intervention used when the pulp is acutely inflamed and a pulp cap is not appropriate.
Search all 206 CDT codes in our dental coding guide.