How long does the removal procedure take?

The removal of a fixed bilateral space maintainer typically takes about 15 to 30 minutes, depending on the complexity and the patient's cooperation.

Are there any risks associated with removing a space maintainer?

Risks are minimal but can include discomfort or minor irritation to the gums. Proper technique minimizes these risks.

What should be done if the space maintainer is loose before the scheduled removal?

If a space maintainer becomes loose, it should be evaluated by a dental professional promptly to determine if early removal is necessary.

Can a space maintainer be reused after removal?

Typically, space maintainers are not reused due to hygiene concerns and changes in the dental arch. A new appliance would be fabricated if needed again.

D1558

Removal of Mandibular Space Maintainer - CDT Code Guide

Preventive/Space Maintenance (Passive Appliances)

Overview

CDT code D1558 pertains to the removal of a fixed bilateral space maintainer in the mandibular arch. This procedure is typically performed when the space maintainer, which was initially placed to preserve space for the proper eruption of permanent teeth, is no longer needed or has fulfilled its purpose. Space maintainers are crucial in pediatric dentistry to prevent the shifting of adjacent teeth following the premature loss of primary teeth. The removal process involves detaching the appliance from the teeth, ensuring that the surrounding oral structures are not damaged. This procedure is commonly carried out in children or adolescents once the permanent teeth are ready to erupt or have already emerged in the correct position.

When to Use This Code

When the permanent teeth are ready to erupt in the space previously maintained.
If the space maintainer is causing irritation or discomfort to the patient.
When the space maintainer has become loose or damaged and is no longer effective.
In preparation for orthodontic treatment that requires the removal of the appliance.
If the patient has reached an age where the appliance is no longer necessary for dental development.

Documentation Requirements

Detailed clinical notes explaining the reason for removal.
Pre- and post-procedure intraoral photographs.
Patient's dental history, including the initial placement of the space maintainer.
Documentation of any complications or issues encountered during removal.
Consent form signed by the patient or guardian.
Post-operative care instructions provided to the patient or guardian.

Billing Considerations

When billing for D1558, it is important to verify the patient's insurance coverage for space maintainer removal, as some plans may have specific guidelines or frequency limitations. Modifiers may be necessary if the procedure is part of a larger treatment plan. Ensure that the removal is not billed too soon after placement unless clinically justified, as some insurers may question the necessity.

Related CDT Codes

D1515 D1516 D1517 D1555 D1556

Frequently Asked Questions

Coverage varies by insurance plan, so it's important to verify with the patient's provider. Many plans cover the removal if deemed medically necessary.

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