Immediate Denture Maxillary - CDT Code Guide
Overview
CDT Code D5130 refers to the procedure of providing an immediate denture for the maxillary arch. This involves creating a denture that is inserted immediately following the extraction of teeth in the upper jaw. The primary advantage of this procedure is that it allows patients to leave the dental office with a complete set of teeth, avoiding the period of edentulism. Immediate dentures are typically used in cases where aesthetics and function need to be restored promptly. However, it's important to note that this code includes only limited follow-up care and does not cover future rebasing or relining procedures, which may be necessary as the patient's gums heal and change shape.
When to Use This Code
- When a patient requires immediate replacement of extracted maxillary teeth.
- In cases where aesthetics and function need to be restored immediately post-extraction.
- For patients who prefer not to have a period without teeth after extractions.
- When planning a phased treatment that begins with immediate dentures.
- In situations where the patient has a medical condition that necessitates immediate denture placement.
Documentation Requirements
- Detailed treatment plan including the need for immediate dentures.
- Clinical notes on the condition of the patient's oral cavity pre-extraction.
- Documentation of the extraction procedure and immediate denture fitting.
- Patient consent forms acknowledging understanding of the procedure and follow-up care limitations.
- Records of any follow-up visits related to the immediate denture.
- Photographic evidence or impressions taken before and after the procedure.
Billing Considerations
When billing for D5130, it's important to note that this code covers only the initial insertion and limited follow-up care. Additional procedures such as rebasing or relining will require separate codes. Insurance plans may have specific frequency limitations for immediate dentures, and common modifiers might include those indicating the arch treated. Verify with the patient's insurance for coverage details and any pre-authorization requirements.
Related CDT Codes
Frequently Asked Questions
The follow-up care for D5130 includes limited adjustments and checks immediately following the procedure but does not cover future rebasing or relining.
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