How does D5214 differ from a complete denture code?

D5214 is specifically for partial dentures that replace some teeth, whereas complete denture codes are for replacing all teeth in an arch.

Can D5214 be used for both temporary and permanent dentures?

Yes, D5214 can be used for both temporary and permanent solutions, depending on the patient's treatment plan and needs.

Are there any specific care instructions for patients with this type of denture?

Patients should follow regular cleaning routines, avoid hard foods, and attend follow-up appointments to ensure proper fit and function.

Is pre-authorization required for billing D5214?

Pre-authorization requirements vary by insurance provider, so it's important to check with the patient's insurance plan for specific guidelines.

D5214

Mandibular Partial Denture - CDT Code Guide

Prosthodontics, removable/Partial Dentures (Including Routine Post-Delivery Care)

Overview

CDT code D5214 refers to a mandibular partial denture with a cast metal framework and resin denture bases. This procedure is essential for patients who require a removable prosthodontic solution to replace missing teeth in the lower jaw. The denture includes retentive and clasping materials, rests, and artificial teeth, providing stability and functionality. Typically, this procedure is used when patients have lost several teeth but still have some natural teeth remaining in the mandibular arch. The metal framework offers durability and strength, while the resin bases ensure comfort and aesthetics. Dental professionals often recommend this option for patients seeking a balance between cost-effectiveness and durability.

When to Use This Code

When a patient has multiple missing teeth in the lower jaw but retains some natural teeth.
For patients seeking a removable prosthodontic solution that offers durability.
In cases where a patient desires a cost-effective alternative to fixed prosthetics.
When the patient has adequate bone support for a partial denture.
For patients who need a temporary solution before considering implants.

Documentation Requirements

Detailed patient dental history and examination notes.
Radiographic evidence supporting the need for a partial denture.
Documentation of missing teeth and existing oral conditions.
Treatment plan outlining the design and materials of the denture.
Patient consent forms acknowledging understanding of the procedure.
Post-delivery care instructions and follow-up visit records.

Billing Considerations

When billing for D5214, be aware of frequency limitations as some insurance plans may restrict the number of partial dentures covered within a specific timeframe. Common modifiers may include those indicating the arch treated or any special circumstances. It's crucial to verify patient insurance benefits and pre-authorization requirements to ensure coverage and minimize out-of-pocket expenses for the patient.

Related CDT Codes

D5213 D5225 D5226 D5110 D5120

Frequently Asked Questions

The cast metal framework provides strength and durability, ensuring the denture remains stable and functional over time.

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