How often can D5120 be billed for the same patient?

Typically, complete dentures can be billed every 5-7 years, but this depends on the patient's insurance policy.

Are adjustments included in the D5120 code?

Yes, routine post-delivery adjustments are included in the D5120 code.

Can D5120 be used for partial dentures?

No, D5120 specifically covers complete dentures for the mandibular arch, not partial dentures.

What should be documented for compliance when using D5120?

Ensure documentation includes patient diagnosis, treatment plan, impressions, fitting details, and follow-up care notes.

D5120

Complete Denture Mandibular - CDT Code Guide

Prosthodontics, removable/Complete Dentures (Including Routine Post-Delivery Care)

Overview

CDT code D5120 refers to the fabrication and delivery of a complete mandibular denture. This procedure involves creating a full set of artificial teeth for the lower jaw, typically used when all natural teeth are missing. The process includes taking impressions, designing the denture, and fitting it to ensure comfort and functionality. Complete dentures are crucial for restoring oral function and aesthetics, improving speech, and enhancing the patient's quality of life. This code is part of the Prosthodontics, removable category, emphasizing its role in replacing missing teeth with removable appliances.

When to Use This Code

When a patient has lost all natural teeth in the lower jaw.
Following extractions of remaining teeth in the mandibular arch.
To replace an existing mandibular denture that no longer fits properly.
For patients requiring a new denture due to significant wear or damage to the current one.
When transitioning from a temporary to a permanent mandibular denture.

Documentation Requirements

Detailed patient history and diagnosis supporting the need for a complete denture.
Clinical notes on the impressions and measurements taken for the denture fabrication.
Documentation of patient consent and discussion of treatment options.
Records of the denture fitting and any adjustments made post-delivery.
Follow-up care notes, including any routine post-delivery adjustments.

Billing Considerations

When billing for D5120, note that insurance plans may have frequency limitations, often covering new dentures every 5-7 years. Common modifiers may include those indicating the initial placement or replacement of a denture. Verify with the patient's insurance for specific coverage details and any required pre-authorizations.

Related CDT Codes

D5110 D5130 D5140 D5211 D5212

Frequently Asked Questions

The D5120 procedure includes the creation and fitting of a complete mandibular denture, along with routine post-delivery care.

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