D7251 is the CDT code for a coronectomy, the intentional removal of the crown of a tooth while deliberately leaving the roots in place. It is used most often on lower third molars whose roots sit close to the inferior alveolar nerve, to reduce the nerve-injury risk a full extraction would carry. D7250, by contrast, removes residual roots.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Use D7251 when performing a coronectomy: removing the crown of a tooth while intentionally leaving the roots in place. The case is almost always a mandibular third molar whose roots are intimately related to the inferior alveolar nerve. Removing the roots would risk nerve injury, so the crown is taken and the roots are deliberately retained to protect the nerve.
This is a planned partial removal, not an incomplete extraction. The decision to leave the roots is made before surgery based on imaging that shows the root-to-nerve relationship. The crown is sectioned and removed, the remaining root tips are reduced below the bone crest, and the site is closed over the retained roots. The rationale is the whole point of the code.
Do NOT use D7251 for: a complete extraction that includes the roots (use the impaction series D7220 through D7241, or D7140 or D7210 for non-impacted teeth). The later retrieval or removal of residual roots that remain in the bone (use D7250). A coronectomy is defined by intentionally retaining the roots, which is the opposite of removing them.
Click any code to see the difference.
Only the crown is removed. The roots are intentionally left in the bone to protect the inferior alveolar nerve. A planned partial removal.
The whole tooth, crown and roots, is removed from a completely bony impaction. Nothing is left behind. A full extraction.
Billing tip: Whether the roots come out is the dividing line. D7240 takes the entire tooth. D7251 leaves the roots on purpose. The narrative should make clear the retained roots were a planned decision to avoid nerve injury, not an incomplete extraction.
Coronectomy is a less common procedure, and some reviewers are not used to seeing it. A claim that arrives without context can read like an incomplete extraction, which invites a denial. A clear narrative that names the procedure as a coronectomy and explains why it was chosen heads off the confusion before the reviewer reaches for a denial.
The rationale for leaving the roots is the heart of a D7251 claim. A CBCT or panoramic image showing the roots in close relationship to the inferior alveolar nerve, paired with a narrative explaining the nerve-injury risk, is what justifies the procedure. Without that documentation the payer has no basis to see why the roots were retained on purpose.
D7250 removes residual roots, while D7251 intentionally leaves them. The two are easy to swap, and a mismatch triggers a denial or a request for records. State plainly that the roots were retained by design to protect the nerve, so the claim is not mistaken for a residual-root removal.
An operative report describing the crown removal supports the claim, and the medical versus dental routing has to be right. Some surgical procedures route to medical coverage depending on the indication and the plan. Confirm where the claim belongs and include the operative report so the documentation reaches the correct payer.
Imaging showing the roots in close relationship to the inferior alveolar nerve. This is the evidence that the nerve risk was real and that retaining the roots was the safer choice.
State that the procedure is a coronectomy and explain why the roots were intentionally left in place. Tie the decision directly to the nerve proximity shown on the imaging.
Describe the crown removal, the reduction of the remaining root tips below the bone crest, and the closure over the retained roots. The report should read clearly as a planned partial removal.
Make clear the roots were retained on purpose, not removed. Stating this in the record keeps the claim from being read as a residual-root removal under D7250.
Check whether the case belongs to the medical or dental payer before submission. Document the routing decision and any pre-authorization number, and include it on the claim.
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Learn about our billing servicesD7251 is the CDT code for a coronectomy, the intentional removal of the crown of a tooth while deliberately leaving the roots in place. It is performed most often on lower third molars whose roots sit close to the inferior alveolar nerve, to reduce the risk of nerve injury that a full extraction would carry.
The intent is opposite. D7251 intentionally leaves the roots in place after removing the crown. D7250 removes residual roots that remain in the bone after a prior extraction. One deliberately retains roots, the other removes them.
D7240 removes the whole tooth, crown and roots, in a complete bony extraction. D7251 removes only the crown and leaves the roots behind on purpose to protect the nerve. A coronectomy is a partial removal by design, not a complete extraction.
Common reasons: payer unfamiliarity with coronectomy, a missing narrative or CBCT documenting nerve proximity and the rationale for leaving the roots, confusion with D7250, missing operative report, and medical versus dental routing.
A CBCT or panoramic image showing the roots in close relationship to the inferior alveolar nerve, a narrative explaining why the roots were intentionally retained, and an operative report describing the crown removal. The rationale for not taking the roots is central.
A coronectomy is chosen when the roots of a tooth, usually a mandibular third molar, are intimately related to the inferior alveolar nerve and removing them would carry a high risk of nerve injury. Leaving the roots reduces that risk while still relieving the symptomatic crown.
Search all 206 CDT codes in our dental coding guide.