D7220 is the CDT code for removal of an impacted tooth whose crown is covered entirely by soft tissue, with no bone obstructing access. The procedure involves a surgical incision through the gingiva to expose and remove the tooth. It is most commonly applied to partially or fully unerupted third molars where a flap must be raised but no bone removal is required.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Get help with D7220 claims →Use D7220 when surgically removing a tooth that is covered only by soft tissue, with no bone overlying the crown. The tooth has not erupted through the gingiva, or has only partially erupted, and a flap must be raised to access the root. No osseous (bone) removal is needed to deliver the tooth.
Common clinical scenarios: Unerupted or partially erupted third molar where the crown is below the gingival margin but above the alveolar crest. Eruption is blocked by tissue only. Flap elevation is required, but sectioning is not necessary and no bone is removed. Most soft tissue impactions present with the crown of the tooth palpable or visible just below the tissue surface.
Do NOT use D7220 for: Simple erupted tooth extractions (use D7140). Surgical extractions of erupted teeth requiring tissue reflection (use D7210). Impacted teeth where any portion of the crown is covered by bone (use D7230 or D7240). Residual root removal (use D7250).
The most common denial occurs when the radiograph shows bone over the crown, but D7220 was billed instead of D7230 or D7240. Payers review the panoramic or periapical film to verify the impaction classification. If bone is visible over any part of the crown on the image, D7220 will be downgraded or denied. Bill the code that matches what the radiograph actually shows.
A current panoramic or periapical radiograph is required for every impacted tooth removal claim. If the image is missing, outdated, or does not clearly show the relationship between the crown and the alveolar bone, the claim will be denied. The film must clearly demonstrate that only soft tissue, not bone, covers the crown.
Some dental plans specifically exclude impacted third molar removal, or exclude it after a certain patient age. Review the patient's benefit plan before scheduling surgery. If the procedure is excluded, discuss payment options with the patient before treatment, not after.
Many plans require prior authorization for any impacted tooth removal code, including D7220. Submitting the claim without an approved pre-auth number results in denial. Submit a pre-auth with the panoramic film and a brief clinical note describing the impaction level and indication for removal.
Must clearly show the impacted tooth position relative to the alveolar crest and confirm that no bone overlies the crown. This is the primary evidence for the D7220 classification versus D7230 or D7240.
Record the clinical and radiographic findings confirming soft tissue impaction. Document that the crown is covered by gingival tissue only and that no bone removal was performed or anticipated.
Document why the tooth was removed. Acceptable indications include pericoronitis, recurrent infection, pathology, orthodontic treatment need, or risk to adjacent teeth. "Patient request" alone is often insufficient for medical necessity.
Confirm that the procedure required incision and tissue reflection, that no bone was removed, and that the tooth was delivered intact or in sections if needed. The operative note must match the billed code.
Check the patient's plan before scheduling. Include the pre-auth number on the claim form. Document the approval date and authorization reference in the patient record.
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Learn about our billing servicesD7220 is the CDT code for removal of a soft tissue impacted tooth. The tooth is unerupted and its crown is covered by gingival tissue only, with no bone overlying it. A surgical incision is required to access and remove the tooth.
D7220 is for soft tissue impaction only, where gum tissue covers the crown and no bone removal is needed. D7230 is for a partially bony impaction, where part of the crown is covered by bone. The radiograph determines which code applies.
D7140 is a simple extraction of a fully erupted tooth. D7220 is a surgical procedure for a tooth that has not erupted, requiring a gingival incision to access it. D7140 requires no tissue reflection to access the tooth.
In some situations, yes. When impacted tooth removal is medically necessary, such as when it causes infection, cysts, or affects orthodontic care, a medical claim may be appropriate using ICD-10 diagnosis codes. Verify the patient's medical plan before submitting.
Common reasons include billing D7220 when radiographs show bone over the crown (should be D7230 or D7240), missing radiographic documentation, plan exclusions for third molar removal, and missing pre-authorization.
Many dental plans require pre-authorization for impacted tooth removal. Submit a pre-auth with a current panoramic or periapical film and a clinical note describing the impaction level. Get approval before scheduling surgery.
Search all 206 CDT codes in our dental coding guide.