Is D5284 covered by insurance?

Coverage for D5284 varies by insurance provider. It's important to verify benefits and obtain pre-authorization if required, as some plans may have restrictions on flexible base dentures.

Can D5284 be used for patients with metal allergies?

Yes, D5284 is an excellent option for patients with metal allergies, as it uses a non-metallic, flexible base material.

How long does it take to fabricate a flexible base partial denture?

The fabrication time can vary, but typically it takes a few weeks from the initial impression to the final fitting, depending on the dental lab's schedule and the complexity of the case.

What are the care instructions for a flexible base partial denture?

Patients should clean their flexible base partial denture daily using a soft brush and non-abrasive cleanser. It's also important to store the denture in water or a denture solution when not in use to maintain its flexibility.

D5284

Removable Unilateral Partial Denture - CDT Code Guide

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

Overview

CDT Code D5284 refers to a removable unilateral partial denture with a one-piece flexible base, including retentive or clasping materials, rests, and teeth, per quadrant. This procedure is designed for patients who require a partial denture that is flexible and comfortable, offering a more aesthetic and less invasive option compared to traditional metal-based partials. Typically, this code is used when a patient is missing teeth in one quadrant and desires a removable solution that provides both functionality and comfort. The flexible base allows for better adaptation to the natural contours of the mouth, making it a preferred choice for patients with specific anatomical considerations or allergies to metal.

When to Use This Code

When a patient requires a partial denture for one quadrant with a flexible base.
In cases where the patient has allergies to metal and needs a non-metallic option.
For patients seeking a more aesthetic and comfortable alternative to traditional metal partials.
When the patient has anatomical considerations that make a flexible base more suitable.
In situations where the patient prefers a removable option for ease of cleaning and maintenance.

Documentation Requirements

Detailed patient records indicating the need for a partial denture.
Clinical notes describing the condition of the remaining teeth and gums.
Documentation of any allergies or contraindications to metal materials.
A treatment plan outlining the design and materials of the denture.
Patient consent forms acknowledging the choice of a flexible base denture.

Billing Considerations

When billing for D5284, ensure that the procedure is documented thoroughly, as insurance companies may have specific requirements for coverage. Frequency limitations may apply, and it is essential to check with the patient's insurance provider regarding coverage for flexible base dentures. Common modifiers may include those indicating the specific quadrant treated. Always verify the patient's benefits to determine if pre-authorization is required.

Related CDT Codes

D5211 D5212 D5225 D5226 D5282

Frequently Asked Questions

A flexible base partial denture is made from a pliable material that adapts to the natural contours of the mouth, providing increased comfort and aesthetics compared to traditional metal-based dentures.

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