Trismus Appliance - CDT Code Guide
Overview
CDT code D5937 refers to the provision of a trismus appliance, a specialized prosthesis designed to assist patients in increasing their oral aperture width. This device is crucial for individuals who experience severe limitations in mouth opening, often following extensive intraoral surgical procedures. The trismus appliance, also known as an occlusal device for mandibular trismus or a dynamic bite opener, helps patients perform essential functions such as eating and maintaining oral hygiene. Various designs of this appliance exist, all aiming to alleviate the challenges associated with restricted oral opening. Dental professionals may recommend this appliance to support recovery and improve the quality of life for affected patients.
When to Use This Code
- Post-operative recovery following extensive intraoral surgery
- Patients experiencing severe trismus due to radiation therapy
- Individuals with restricted oral opening from trauma or injury
- Patients with neurological conditions affecting jaw mobility
- Cases where oral hygiene maintenance is compromised due to limited mouth opening
Documentation Requirements
- Detailed patient diagnosis and indication for the trismus appliance
- Clinical notes outlining the necessity of the appliance for oral function
- Description of the appliance type and design used
- Patient consent and understanding of the appliance's purpose
- Progress notes documenting patient improvement and appliance effectiveness
Billing Considerations
When billing for CDT code D5937, it is important to verify the patient's insurance coverage for maxillofacial prosthetics, as not all plans may cover this service. Frequency limitations may apply, so check with the payer for any restrictions. Common modifiers may include those indicating the appliance's customization or adjustments. Accurate documentation is essential to justify the medical necessity of the appliance.
Related CDT Codes
Frequently Asked Questions
A trismus appliance is used to help patients increase their oral aperture width, particularly after surgery or due to conditions causing restricted mouth opening.
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