Add Metal Substructure - CDT Code Guide
Overview
CDT code D5876 pertains to the addition of a metal substructure to an acrylic complete denture, applied per arch. This procedure is typically used to enhance the strength and durability of a denture, providing better support and longevity. Dental professionals often recommend this procedure for patients who require additional reinforcement due to heavy occlusal forces or for those who have experienced repeated denture fractures. The metal substructure acts as a framework that supports the acrylic material, ensuring a more stable and resilient prosthetic solution.
When to Use This Code
- When a patient has experienced multiple fractures in their acrylic complete denture.
- In cases where the patient exhibits heavy occlusal forces that may compromise the integrity of a standard acrylic denture.
- For patients requiring additional reinforcement due to anatomical considerations or previous denture failures.
- When upgrading an existing acrylic denture to improve its structural integrity.
- In situations where the patient’s lifestyle or occupational demands necessitate a more durable denture solution.
Documentation Requirements
- Detailed clinical notes explaining the need for a metal substructure.
- Pre-treatment photographs and radiographs, if applicable, to support the necessity of the procedure.
- A comprehensive treatment plan outlining the steps and materials used.
- Patient consent forms acknowledging understanding of the procedure and associated costs.
- Documentation of any previous denture failures or issues that justify the addition of a metal substructure.
Billing Considerations
When billing for D5876, it is important to note any frequency limitations set by the patient's insurance provider. Common modifiers may include those indicating the arch treated (upper or lower). Insurance policies may vary in their coverage of this procedure, so pre-authorization is recommended to ensure patient benefits. Additionally, this code is typically used in conjunction with other prosthodontic codes, so proper bundling and unbundling practices should be observed.
Related CDT Codes
Frequently Asked Questions
The metal substructure provides additional strength and support to the denture, reducing the risk of fractures and improving durability.
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