Maxillofacial Defect Repair - CDT Code Guide
Overview
CDT code D7955 pertains to the repair of maxillofacial soft and/or hard tissue defects, focusing on the reconstruction of surgical, traumatic, or congenital defects of the facial bones, including the mandible. This procedure is essential for restoring both the form and function of the facial structure. It may involve the use of graft materials alongside soft tissue procedures, though it excludes the procurement of the graft itself. Multiple surgical approaches may be necessary to achieve optimal results. This code specifically excludes reconstruction for prosthetic considerations in edentulous maxilla and mandible cases. Dental professionals often utilize this code in complex cases where facial integrity needs to be restored due to injury, surgery, or congenital anomalies.
When to Use This Code
- Reconstruction following facial trauma resulting in bone defects.
- Repair of congenital defects affecting the facial bones.
- Post-surgical reconstruction after tumor removal in the facial region.
- Restoration of facial structure following significant infection-related bone loss.
- Complex facial reconstructive surgery requiring multiple approaches.
Documentation Requirements
- Detailed surgical report outlining the defect and reconstruction process.
- Pre-operative and post-operative imaging to document the defect and repair.
- Description of graft materials used and their sources.
- Clinical notes on the necessity of multiple surgical approaches, if applicable.
- Patient consent forms specific to the reconstructive procedure.
- Exclusion of procedures related to prosthetic reconstruction for edentulous cases.
Billing Considerations
When billing for D7955, it's important to note that this code does not cover the procurement of graft materials, which should be billed separately if applicable. There may be frequency limitations based on the patient's insurance policy, and it is crucial to verify coverage beforehand. Common modifiers might include those indicating multiple procedures or bilateral procedures, depending on the surgical approach. Always check with the patient's insurance provider for specific coverage details and pre-authorization requirements.
Related CDT Codes
Frequently Asked Questions
No, D7955 does not include reconstruction for prosthetic considerations in edentulous maxilla and mandible cases.
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