# Excision of Maxillary Exostosis



## TnRushFan (Aug 3, 2018)

I am stumped!

Oral surgeon spent 2 hours removing 4 buccal exostosis via 4 separate incisions at 4 separate locations.

After much research I came up with 41823 Excision of osseous tuberosities, dentoalveolar structures...it is a direct crosswalk of D7471 removal of lateral exostosis maxilla and mandible. My lead coder thinks it should be 21032 removal of maxillary torus...I strongly disagree...
...and, our NCCI edits program will only allow one unit of the code...it says only 1 unit can be billed - no modifier override

I believe tori are on the inside of the dental structures and buccal exostosis are on the outside of the dental structures even though they are both bony growths.

Any thoughts?  Thanks in advance...

operative note excerpt:

*right maxilla
* FTMP was elevated
* distobuccal release at tooth #2
* remove the buccal exostosis
* Site was closed

* right mandible 
*FTMP was elevated 
*a distobuccal release at tooth #31
* remove the buccal exostosis
* Site was closed

* left maxilla 
* FTMP was elevated 
* distobuccal release at tooth #15
* remove the buccal exostosis
* Site was closed

*left mandible
* distobuccal release at tooth #21
* remove the buccal exostosis
* Site was closed

https://www.aetnadental.com/professionals/pdf/oral-surgery-dental-in-nature.pdf


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