D7285 — Biopsy of oral tissue — hard (bone, tooth)
D7285 biopsies hard tissue, taking a sample of bone or tooth rather than of gum or lining.
This is one of eleven closely related biopsy and lesion excision codes. The treatment is explained in full in the biopsy and lesion excision guide — this page is about what makes this particular code different.
Below: the conditions built into this particular code, a realistic fee range, what happens when it reaches an insurer, and a side-by-side comparison with the codes most often substituted for it.
Told apart from the codes it is confused with
D7286 — Biopsy of oral tissue — soft: It is the same procedure specified for soft rather than for hard bone tooth.
D7410 — Excision of benign lesion — up to 1.25 cm: It removes a benign lump or patch measuring up to 1.25 centimetres, with the specimen sent for laboratory diagnosis.
D7411 — Excision of benign lesion — greater than 1.25 cm: It removes a benign lesion larger than 1.25 centimetres, which means wider margins and more closure than the small-lesion code.
D7412 — Excision of benign lesion — complicated: It is the complicated variant, requiring a supporting narrative.
D7285 sits in a group of eleven codes in total; the remainder are linked at the foot of this page. These distinctions exist because they change what was actually done. A claim for D7285 when the record describes one of the others is not a technicality — it is the difference between a paid claim and a returned one.
Every code in this group
These codes describe the same broad procedure and differ in one respect each. Each has its own page with its own fee range and coverage notes.
Questions about D7285
What procedure is D7285?
It is the oral and maxillofacial surgery code for biopsy of oral tissue, hard, bone, tooth, and it means that specific procedure and no other.
What is the typical fee for D7285?
Expect $450–$1,200. Ask for the number in writing, because the code carries no fee of its own and every practice sets its own.
How do dental plans handle D7285?
Typically, yes — basic / major oral surgery benefits, typically 70–80%. What varies between plans is the frequency limit rather than whether the procedure is covered at all.
What is the difference between D7285 and D7286?
D7286 is biopsy of oral tissue, soft: it is the same procedure specified for soft rather than for hard bone tooth. Nothing else separates them, which is exactly why a claim submitted under the wrong one of the two is such a common correction.
Also known as: oral biopsy, mouth lesion, oral cancer, lesion excision, pathology.