Immediate Maxillary Partial Denture - CDT Code Guide
Overview
CDT code D5223 refers to the fabrication and placement of an immediate maxillary partial denture with a cast metal framework and resin denture bases. This procedure is designed to replace missing teeth in the upper jaw immediately after extraction, providing patients with improved aesthetics and function. The denture includes retentive and clasping materials, rests, and artificial teeth, offering a durable and stable solution. Typically, this procedure is used when patients require an immediate solution following tooth loss due to decay, trauma, or periodontal disease. The immediate placement helps maintain facial structure and allows for better adaptation to the new prosthesis. It is important to note that this code covers limited follow-up care and does not include future rebasing or relining procedures, which may be necessary as the patient's oral condition changes over time.
When to Use This Code
- When a patient requires immediate replacement of missing upper teeth post-extraction.
- In cases where maintaining facial aesthetics immediately after tooth loss is crucial.
- For patients who need a temporary solution while waiting for a more permanent prosthetic.
- When a patient has lost multiple teeth due to trauma and needs immediate functional restoration.
- In scenarios where the patient is not a candidate for immediate implant placement.
Documentation Requirements
- Detailed patient history and clinical examination notes.
- Pre-treatment photographs and radiographs showing the condition of the oral cavity.
- Documentation of the extraction procedure and immediate denture placement.
- Patient consent forms outlining the procedure and follow-up care.
- Detailed notes on the materials used in the denture fabrication.
- Follow-up care instructions provided to the patient.
Billing Considerations
When billing for D5223, it's important to note that this code includes limited follow-up care but excludes future rebasing or relining. Frequency limitations may apply, and it's crucial to verify with the patient's insurance provider regarding coverage specifics. Common modifiers may include those indicating the arch treated or any additional procedures performed concurrently. Ensure that all documentation is thorough to avoid claim denials.
Related CDT Codes
Frequently Asked Questions
The D5223 code includes the immediate placement of a maxillary partial denture with a cast metal framework and resin bases, along with limited follow-up care.
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