Immediate Mandibular Partial Denture - CDT Code Guide
Overview
CDT Code D5222 pertains to the fabrication and delivery of an immediate mandibular partial denture with a resin base. This procedure is essential for patients who require immediate replacement of missing teeth in the lower jaw, often following extractions. The denture includes retentive and clasping materials, rests, and teeth, providing both functional and aesthetic benefits. Typically, this code is used in scenarios where patients need a quick solution to restore oral function and appearance while waiting for a more permanent prosthetic solution. The code covers limited follow-up care but does not include future rebasing or relining procedures, which are billed separately.
When to Use This Code
- When a patient requires immediate replacement of missing mandibular teeth after extractions.
- For patients who need a temporary solution while waiting for a permanent denture.
- In cases where a patient has lost multiple teeth in the lower jaw and needs immediate restoration.
- When a patient is transitioning from natural teeth to a full denture and requires interim support.
- For patients who have had recent oral surgery and need immediate prosthetic intervention.
Documentation Requirements
- Detailed patient history and clinical notes supporting the need for an immediate partial denture.
- Documentation of the number and location of missing teeth.
- Clinical photographs or radiographs showing the mandibular arch condition.
- A treatment plan outlining the immediate denture process and follow-up care.
- Patient consent forms acknowledging understanding of the procedure and its limitations.
Billing Considerations
When billing for D5222, note that it covers only the initial fabrication and limited follow-up care. Rebasing or relining procedures are not included and should be billed separately. Be aware of frequency limitations as some insurance plans may restrict how often this procedure can be billed. Common modifiers include those indicating the arch (mandibular) and any special circumstances. Verify with the patient's insurance for coverage details and pre-authorization requirements.
Related CDT Codes
Frequently Asked Questions
The D5222 code includes the fabrication and delivery of an immediate mandibular partial denture with a resin base, retentive/clasping materials, rests, and teeth. It also covers limited follow-up care.
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