Repair of Orthodontic Appliance - CDT Code Guide
Overview
CDT code D8696 refers to the repair of orthodontic appliances specifically for the maxillary arch. This procedure is essential when functional appliances or palatal expanders require adjustments or repairs due to wear, damage, or patient growth. It does not cover repairs to standard fixed orthodontic appliances or brackets. Typically, this code is used in scenarios where an orthodontic device has been compromised and needs professional attention to restore its function and ensure continued orthodontic treatment success.
When to Use This Code
- Repairing a damaged palatal expander due to patient misuse.
- Adjusting a functional appliance that has become ineffective due to patient growth.
- Fixing a maxillary appliance that has been compromised during regular use.
- Restoring a maxillary appliance after accidental damage.
- Reinforcing a maxillary appliance that has loosened over time.
Documentation Requirements
- Detailed description of the damage and repair performed.
- Date of the repair service.
- Patient's orthodontic treatment plan showing the necessity of the appliance.
- Photographic evidence of the appliance before and after repair.
- Orthodontist's notes on the repair process and materials used.
Billing Considerations
When billing for D8696, ensure that the repair is not part of routine maintenance covered under the original appliance placement. Check with insurance providers for coverage specifics, as some may require pre-authorization. Frequency limitations may apply, so verify patient benefits. Common modifiers may include those indicating the specific arch or quadrant involved.
Related CDT Codes
Frequently Asked Questions
No, D8696 is not used for repairing brackets; it is specific to functional appliances and palatal expanders.
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