Maxillary Partial Denture - CDT Code Guide
Overview
CDT code D5225 refers to the procedure for creating a maxillary partial denture with a flexible base. This type of denture includes retentive and clasping materials, rests, and teeth, providing a comfortable and adaptable solution for patients missing some of their upper teeth. The flexible base offers enhanced comfort and fit, making it an ideal choice for patients who may have difficulty with traditional rigid dentures. This procedure is typically performed by a prosthodontist and involves taking precise measurements and molds of the patient's mouth to ensure a custom fit. The flexible base allows for better adaptation to the natural contours of the mouth, improving both function and aesthetics.
When to Use This Code
- When a patient is missing multiple upper teeth and requires a partial denture.
- In cases where a patient has difficulty tolerating rigid dentures.
- For patients seeking a more comfortable and adaptable denture solution.
- When a patient has irregularities in the maxillary arch that require a flexible base.
- In situations where a patient desires improved aesthetics and function with a partial denture.
Documentation Requirements
- Detailed patient dental history and examination notes.
- Documentation of missing teeth and need for a partial denture.
- Records of impressions and molds taken for the denture fabrication.
- Notes on patient consultations discussing denture options and preferences.
- Billing records indicating the use of flexible base materials.
- Post-delivery care instructions and follow-up appointment notes.
Billing Considerations
When billing for D5225, it's important to note any frequency limitations set by insurance providers, as some may restrict how often a partial denture can be replaced or repaired. Modifiers may be necessary if the procedure is part of a larger treatment plan. Always verify with the patient's insurance to ensure coverage for flexible base materials, as some plans may have specific exclusions or require prior authorization.
Related CDT Codes
Frequently Asked Questions
A flexible base denture is made from materials that allow it to adapt more easily to the contours of the mouth, providing greater comfort and a more natural fit compared to traditional rigid dentures.
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