Dental Code D0474: Accession of tissue, gross and microscopic examination, including assessment of surgical margins for presence of disease, preparation and transmission of written report

Dental Code D0474 is a specific code used in dentistry to describe a procedure known as "accession of tissue, gross and microscopic examination, including assessment of surgical margins for the presence of disease, preparation, and transmission of a written report." This code is important for dentists and oral surgeons as it allows them to accurately document and report the examination of tissue samples taken during oral surgical procedures. 

Dental Code D0474 refers to the examination of tissue samples obtained during oral surgeries. It involves a comprehensive assessment of the tissue at both macroscopic (gross) and microscopic levels. The purpose of this examination is to evaluate the surgical margins for the presence of disease, such as tumors or other abnormalities, and to prepare a detailed written report based on the findings. This code ensures that the examination and reporting process adheres to a standardized protocol.

The first step in the process is to collect a tissue sample during a surgical procedure. This can include biopsies, excisions, or other oral surgical interventions. The surgeon carefully removes a small section of tissue from the affected area using specialized instruments. The tissue sample is then properly handled and preserved to maintain its integrity for subsequent examination. After the tissue sample is collected, it is typically placed in a fixative solution, such as formalin, to prevent decay and maintain its structural integrity. This ensures that the tissue remains suitable for further processing and analysis, allowing for accurate assessment of the surgical margins and identification of any disease presence during the subsequent examination. Proper handling and preservation of the tissue sample are crucial for obtaining reliable and informative results.

Once the tissue sample is collected, it undergoes a gross examination. This examination involves a visual assessment of the tissue specimen without the aid of a microscope. The purpose is to observe any visible abnormalities, such as tumors, cysts, or other pathological conditions. The surgeon examines the tissue sample for any signs of disease, ensuring that all relevant areas are thoroughly inspected. During the gross examination, the surgeon may also palpate the tissue sample to detect any irregularities or changes in texture. This hands-on approach allows for a comprehensive assessment of the tissue's physical characteristics and helps to identify any subtle abnormalities that may not be visible to the naked eye alone. The combination of visual inspection and palpation enhances the accuracy of the gross examination and aids in the identification of potential diseases or conditions.

Following the gross examination, the tissue sample is processed for a microscopic examination. This involves the preparation of thin sections of the tissue, which are then mounted on glass slides. The slides are stained to enhance the visibility of cellular structures. A pathologist or oral histologist examines these slides under a microscope to assess the cellular composition, identify any abnormal cell growth, or detect signs of disease. During the microscopic examination, the pathologist or oral histologist may employ various staining techniques, such as hematoxylin and eosin (H&E), to highlight specific cellular components and differentiate between healthy and diseased tissues. Additionally, advanced imaging techniques, such as immunohistochemistry or molecular analysis, may be utilized to further characterize the tissue sample and provide additional information about specific biomarkers or genetic abnormalities. These techniques enhance the diagnostic capabilities of the microscopic examination and contribute to a more comprehensive understanding of the tissue's pathological features.

During the microscopic examination, particular attention is given to evaluating the surgical margins. The surgical margins refer to the edges of the tissue sample where the surgical intervention took place. The pathologist examines these margins to determine if there is any evidence of disease remaining at the edges. This assessment is crucial for determining the success of the surgical procedure and helps guide further treatment decisions.

Once the examination is complete, a comprehensive written report is prepared. This report includes detailed information about the gross and microscopic findings, the assessment of surgical margins, and any diagnoses or recommendations. The report is usually generated by the pathologist or oral histologist who performed the examination. It is then transmitted to the referring dentist or oral surgeon, who uses the information to guide further treatment planning.

Dental Code D0474 is a specific code used in dentistry to describe the process of accessioning tissue, gross and microscopic examination, assessment of surgical margins, and preparation of a written report. This procedure plays a critical role in evaluating tissue samples obtained during oral surgical procedures. By examining the tissue at both macroscopic and microscopic levels, dentists and oral surgeons can accurately identify the presence of diseases and provide appropriate treatment recommendations. The detailed written report generated through this process serves as a valuable tool for effective communication among healthcare professionals and aids in delivering optimal patient care.

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