Nasal Prosthesis - CDT Code Guide
Overview
CDT code D5913 refers to the fabrication of a nasal prosthesis, which is an artificial nose designed to restore part or all of the nasal structure. This procedure involves creating an original mold from which the prosthesis is crafted. The mold can be reused for additional prostheses, provided there are no significant changes in the patient's tissue. This service is crucial for patients who have lost nasal structures due to trauma, surgery, or congenital conditions. The nasal prosthesis not only improves aesthetic appearance but also enhances the patient's quality of life by restoring nasal function.
When to Use This Code
- Patients who have undergone surgical removal of nasal structures due to cancer.
- Individuals with congenital nasal deformities requiring prosthetic correction.
- Patients who have experienced traumatic injury resulting in loss of nasal tissue.
- Cases where previous nasal prostheses need replacement due to wear or damage.
- Situations where a temporary prosthesis is needed during reconstructive surgery planning.
Documentation Requirements
- Detailed patient history and diagnosis necessitating the prosthesis.
- Clinical notes describing the extent of nasal tissue loss or deformity.
- Photographic evidence of the nasal area pre- and post-prosthesis.
- Documentation of the mold creation and any subsequent adjustments.
- Patient consent forms acknowledging understanding of the procedure.
Billing Considerations
When billing for D5913, ensure that the procedure is not performed more frequently than necessary, as molds can be reused. Common modifiers include those indicating bilateral procedures if applicable. Verify with insurance providers regarding coverage for prosthetic devices, as some plans may have specific limitations or require pre-authorization.
Related CDT Codes
Frequently Asked Questions
A nasal prosthesis can last several years if properly maintained, but it may need replacement if the patient's facial structure changes or the prosthesis becomes damaged.
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