Can D5670 be used for partial denture repairs?

No, D5670 is specifically for complete replacements, not repairs of existing dentures.

Is pre-authorization required for D5670?

Pre-authorization may be required depending on the patient's insurance plan, so it's important to check coverage details.

How often can D5670 be billed?

Frequency limitations vary by insurance provider, but typically, replacements are covered every 5-7 years.

What materials are used in the D5670 procedure?

The procedure involves acrylic for the teeth and a cast metal framework for support and durability.

D5670

Maxillary Denture Replacement - CDT Code Guide

Prosthodontics, removable/Repairs to Partial Dentures

Overview

CDT Code D5670 pertains to the replacement of all teeth and acrylic cast metal framework in the maxillary arch. This procedure is part of the prosthodontics, removable category and specifically addresses repairs to partial dentures. It involves creating a new denture framework that includes all teeth, supported by a metal structure, to ensure durability and functionality. Typically, this code is used when a patient's existing maxillary partial denture is no longer serviceable due to wear, damage, or changes in the oral cavity that affect fit and function. Dental professionals must assess the patient's oral health, the condition of the current denture, and the need for a complete replacement to restore proper oral function and aesthetics.

When to Use This Code

When the existing maxillary partial denture is irreparably damaged.
In cases where the patient has experienced significant oral changes affecting denture fit.
When all teeth on the maxillary denture need replacement due to wear.
If the acrylic framework has fractured and cannot be repaired.
When upgrading to a more durable metal framework is necessary.

Documentation Requirements

Detailed patient history and reason for replacement.
Clinical notes on the condition of the existing denture.
Impressions and models of the patient's oral cavity.
Documentation of patient consent for the procedure.
Insurance pre-authorization if required.
Post-procedure evaluation notes.

Billing Considerations

Ensure to verify the patient's insurance coverage for prosthodontic procedures, as some plans may have frequency limitations on denture replacements. Common modifiers include those indicating the arch (maxillary) and any special circumstances. It's important to document the necessity for replacement thoroughly to avoid claim denials.

Related CDT Codes

D5213 D5214 D5671 D5863 D5864

Frequently Asked Questions

D5670 is used for maxillary replacements, while D5671 is for mandibular replacements.

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