Maxillary Partial Denture - CDT Code Guide
Overview
The CDT code D5213 refers to the procedure for creating a maxillary partial denture with a cast metal framework and resin denture bases. This procedure is essential for patients who have lost some of their upper teeth and require a removable partial denture to restore function and aesthetics. The process involves crafting a metal framework that fits the upper jaw, onto which resin bases and artificial teeth are attached. This type of denture is designed to be durable and provide a comfortable fit, while also allowing for the natural movement of the mouth. Dental professionals often recommend this procedure for patients who need a stable and long-lasting solution for missing teeth in the upper jaw.
When to Use This Code
- Patient has multiple missing teeth in the upper jaw and desires a removable solution.
- Existing partial denture needs replacement due to wear or damage.
- Patient requires a cost-effective alternative to fixed prosthodontics.
- Patient prefers a removable option over fixed bridges or implants.
- Patient has sufficient remaining teeth to support a partial denture.
Documentation Requirements
- Detailed patient dental history and charting of missing teeth.
- Clinical notes on the necessity of a partial denture.
- Impressions and models of the patient's upper arch.
- Documentation of patient consent and treatment plan.
- Records of any previous prosthodontic appliances.
- Post-delivery care instructions and follow-up notes.
Billing Considerations
When billing for D5213, it is important to check the patient's insurance plan for coverage of removable prosthodontics, as some plans may have frequency limitations or specific criteria for coverage. Modifiers may be necessary if the procedure is part of a larger treatment plan. Ensure that the documentation supports the medical necessity of the partial denture to avoid claim denials.
Related CDT Codes
Frequently Asked Questions
D5213 is for a maxillary partial denture, while D5214 is for a mandibular partial denture, both with cast metal frameworks.
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