How often can D5993 be billed?

The frequency depends on the patient's insurance policy. It's important to verify coverage limits with the insurer.

Is D5993 applicable for both intra-oral and extra-oral prostheses?

Yes, D5993 covers maintenance and cleaning for both intra-oral and extra-oral maxillofacial prostheses.

What should be included in the report for D5993?

The report should include details of the cleaning procedure, the condition of the prosthesis, and any recommendations for future care.

Are there any common modifiers used with D5993?

Modifiers may be used to indicate the location of the prosthesis, such as whether it is intra-oral or extra-oral.

D5993

Maxillofacial Prosthesis Maintenance - CDT Code Guide

Maxillofacial Prosthetics/Other Removable Prosthetic Services

Overview

CDT code D5993 pertains to the maintenance and cleaning of maxillofacial prostheses, which can be either extra-oral or intra-oral. This procedure is crucial for ensuring the longevity and functionality of the prosthesis, as well as the comfort and oral health of the patient. Typically, this service involves thorough cleaning and maintenance tasks that go beyond routine adjustments, ensuring that the prosthesis remains in optimal condition. Dental professionals often perform this procedure in cases where the prosthesis is exposed to factors that could compromise its integrity or when regular upkeep is necessary to prevent complications. Understanding the nuances of this code is essential for dental professionals who work with patients requiring maxillofacial prosthetics.

When to Use This Code

When a patient requires cleaning of a maxillofacial prosthesis due to buildup or contamination.
During routine maintenance visits for patients with long-term maxillofacial prosthetics.
When the prosthesis shows signs of wear that could lead to hygiene issues if not addressed.
In cases where the prosthesis has been exposed to environments that could lead to deterioration.
When a patient reports discomfort or issues with the prosthesis that are not related to fit.

Documentation Requirements

Detailed description of the cleaning and maintenance procedures performed.
Patient's medical and dental history relevant to the prosthesis.
Condition of the prosthesis before and after the procedure.
Any recommendations for future maintenance or care.
Patient's consent and understanding of the procedure.
Photographic evidence if applicable, especially for insurance purposes.

Billing Considerations

When billing for D5993, it's important to note that this code is specifically for maintenance and cleaning, not adjustments. Frequency limitations may apply based on the patient's insurance policy, so it's advisable to verify coverage beforehand. Common modifiers may include those indicating the location of the prosthesis (extra-oral vs. intra-oral). Ensure that all documentation is thorough to avoid claim denials.

Related CDT Codes

D5992 D5994 D5999 D5911 D5912

Frequently Asked Questions

No, D5993 is specifically for maintenance and cleaning, not for adjustments.

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