D7250 is the CDT code for removal of residual tooth roots using a cutting procedure. It applies when root fragments or retained roots remain in the alveolar bone after a tooth is no longer present, and their removal requires tissue incision, reflection, or osseous access. This is a surgical procedure, not a simple extraction.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Get help with D7250 claims →Use D7250 when removing retained root tips or root fragments where no tooth crown is present. The roots must require a surgical or cutting approach, meaning simple forcep elevation is not sufficient. Tissue must be incised and reflected, or bone may need to be removed to access the root structure.
Common clinical scenarios: Retained root tips discovered on a radiograph during treatment planning or implant workup. Root fragments separated during a previous extraction that were not retrieved at the time. Long-standing retained roots associated with infection, granuloma, or cyst formation. Root tips below the crestal bone level that cannot be removed without flap access or bur use.
Do NOT use D7250 for: Extraction of a tooth where the crown is still present, even if only root structure is visible clinically (use D7140 or D7210 as appropriate). Root canal treatment or root amputation. Apicoectomy procedures (see D7140 series). Removal of an impacted tooth where the crown is still present (use D7220, D7230, or D7240).
Payers require a periapical or panoramic radiograph clearly showing the retained root or root fragment in the bone. If the image is missing or does not clearly show residual root structure, the claim will be denied. Obtain a current, diagnostic-quality periapical film of the site before proceeding and include it with the claim.
D7250 is only appropriate when there is no remaining crown structure. If any portion of the clinical crown is still present, the procedure should be coded as a surgical extraction (D7210) rather than residual root removal. Payers audit this distinction carefully because D7250 is a separate procedure from the original extraction workflow.
A root tip that fractures during an extraction on the same visit should be documented carefully. If the root tip removal occurs as part of an extraction on the same date of service, payers may bundle it into the original extraction code. D7250 is most defensible when the root removal is a separate encounter or when the fragment removal required substantially more effort than the original procedure.
The operative note must confirm that a cutting procedure was used. Documentation should describe flap reflection, bur use, or other surgical steps taken. Simply noting "root tip removed" without describing the technique will not satisfy most payer requirements for D7250 versus a simpler retrieval approach.
Must clearly show the retained root or root fragment within the alveolar bone. The image should confirm there is no remaining crown structure, and should document the size and location of the root. This is the primary justification for the code.
Document that the tooth crown is absent and that only root structure remains. Include the tooth number, history of prior extraction or tooth loss, and the clinical finding that prompted the procedure.
Describe the approach used. Specifically confirm that incision and tissue reflection were performed, and whether bone removal or bur use was required. The note must support the "cutting procedure" descriptor in the D7250 code definition.
Document why the retained root required removal. Indications include infection, associated pathology, interference with implant placement, or risk to adjacent structures. Asymptomatic roots in elderly or medically compromised patients are sometimes left in place, so the rationale for removal should be explicit.
Verify benefit requirements before scheduling. Submit a pre-auth with the radiograph and a brief clinical note. Include the authorization number on the claim.
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Learn about our billing servicesD7250 is the CDT code for removal of residual tooth roots using a cutting procedure. It applies when root fragments or retained roots remain in the bone after the tooth crown is no longer present, requiring surgical access to retrieve them.
D7140 is for simple extraction of an erupted tooth. D7250 is for removing root fragments or residual roots where no crown remains, and always requires a cutting or surgical approach. Use D7140 only when an intact or near-intact tooth is being extracted through simple elevation.
D7210 is a surgical extraction of a tooth that still has a crown present but requires bone removal or sectioning. D7250 is for retained roots where no crown is present. The crown status is the defining distinction between these two codes.
In some cases, yes. When retained roots are causing infection, cyst formation, or other medical complications, a medical claim may be submittable using appropriate ICD-10 diagnosis codes. Verify the patient's medical plan and payer policy before submitting.
Common reasons include lack of radiographic evidence showing the retained root, billing D7250 when a crown is still present (should be D7210), bundling by payers when done on the same day as an extraction, and operative notes that do not describe a surgical or cutting approach.
Yes, if the root tip removal was a distinct, additional surgical procedure. Document clearly that the root retrieval required separate incision, reflection, or bur use beyond the original extraction. Payers may bundle same-day claims, so detailed documentation is critical for a successful appeal if denied.
Pre-authorization requirements vary by plan. Submit a pre-auth with a current radiograph clearly showing the retained root and a brief clinical note explaining why surgical removal is necessary before scheduling the procedure.
Search all 206 CDT codes in our dental coding guide.