Can this procedure be done in-office?

While minor adjustments can be made in-office, most repairs to the cast partial framework require laboratory work.

Is prior authorization required for this code?

Prior authorization requirements vary by insurance provider, so it's essential to check with the patient's insurance plan.

How often can a patient have this repair done under insurance?

Frequency limitations depend on the insurance policy, but many plans allow for repairs every 1-2 years.

What should a patient do if their denture breaks while traveling?

Patients should seek a local dentist for temporary repairs and contact their regular dentist for a permanent solution upon returning home.

D5622

Repair Cast Partial Framework, Maxillary - CDT Code Guide

Prosthodontics, removable/Repairs to Partial Dentures

Overview

CDT code D5622 is used for the repair of a cast partial framework in the maxillary arch. This procedure is essential when a partial denture's metal framework, which supports artificial teeth, becomes damaged or compromised. Common scenarios include fractures or distortions in the framework due to wear and tear or accidental damage. The repair process involves assessing the damage, removing the denture from the patient's mouth, and performing the necessary repairs in a dental laboratory. This code is crucial for maintaining the functionality and comfort of partial dentures, ensuring that patients can continue to use their prosthetic devices effectively.

When to Use This Code

When a patient presents with a fractured maxillary cast partial framework.
In cases where the framework has become distorted and affects the fit of the denture.
When the integrity of the metal framework is compromised due to corrosion or wear.
If a patient reports discomfort or instability with their current maxillary partial denture.
During routine maintenance checks when minor repairs are needed to extend the life of the denture.

Documentation Requirements

Detailed description of the damage to the partial framework.
Clinical notes on the patient's symptoms and reasons for repair.
Photographic evidence of the framework before and after repair, if possible.
Laboratory work order specifying the type of repair performed.
Patient consent form acknowledging understanding of the repair process.

Billing Considerations

When billing for D5622, consider that some insurance plans may have frequency limitations on denture repairs. It's important to verify coverage details with the patient's insurance provider. Common modifiers may include those indicating the arch (e.g., maxillary vs. mandibular). Ensure that the repair is documented thoroughly to avoid claim denials.

Related CDT Codes

D5610 D5630 D5640 D5650 D5660

Frequently Asked Questions

The turnaround time can vary, but typically it takes 1-2 weeks, depending on the complexity of the repair and the dental laboratory's schedule.

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