Repair of Orthodontic Appliance - CDT Code Guide
Overview
CDT code D8697 is used for the repair of orthodontic appliances specifically on the mandibular arch. This code is applicable when the repair does not involve standard fixed orthodontic appliances or brackets but includes functional appliances and palatal expanders. Typical scenarios for using this code include adjustments or repairs needed due to wear and tear, accidental damage, or when the appliance no longer fits properly due to changes in the patient's oral structure. Understanding the clinical context of D8697 is crucial for ensuring accurate billing and effective patient care.
When to Use This Code
- Repair of a mandibular functional appliance that has been damaged
- Adjustment of a mandibular palatal expander that no longer fits properly
- Repair of a mandibular appliance due to accidental damage
- When a mandibular appliance requires modification to improve function
- Correction of issues with a mandibular appliance that affects patient comfort
Documentation Requirements
- Detailed description of the appliance and the specific repair performed
- Clinical notes indicating the necessity of the repair
- Photographic evidence of the damage prior to repair
- Patient consent for the repair procedure
- Documentation of any materials used in the repair process
- Record of the patient's orthodontic treatment plan and progress
Billing Considerations
When billing for D8697, it is important to note that this code should not be used for repairs involving brackets or standard fixed appliances. Frequency limitations may apply based on the patient's insurance plan, and it is advisable to check with the insurer for specific coverage details. Common modifiers may include those indicating the specific arch or quadrant involved. Ensure that the repair is clearly documented to avoid claim denials.
Related CDT Codes
Frequently Asked Questions
No, D8697 is specifically for repairs on the mandibular arch. For maxillary repairs, a different code should be used.
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