Removable Unilateral Partial Denture - CDT Code Guide
Overview
CDT code D5286 refers to the fabrication and fitting of a removable unilateral partial denture made from one piece of resin. This procedure includes all necessary retentive and clasping materials, rests, and teeth for one quadrant. Typically used when a patient is missing some teeth in a single quadrant, this denture provides a cost-effective and less invasive alternative to fixed partial dentures. Dental professionals often recommend this solution for patients who require a temporary or transitional prosthetic option, or for those who cannot undergo more extensive dental procedures due to health or financial reasons.
When to Use This Code
- When a patient is missing multiple teeth in one quadrant and requires a removable prosthetic solution.
- For patients who need a temporary prosthetic while awaiting more permanent dental work.
- In cases where patients have financial constraints that prevent them from opting for fixed partial dentures.
- When a patient has medical conditions that contraindicate surgical procedures for fixed dentures.
- For patients who prefer a removable option for ease of cleaning and maintenance.
Documentation Requirements
- Detailed chart notes indicating the necessity for a unilateral partial denture.
- Patient's dental and medical history supporting the choice of a removable prosthetic.
- Documentation of the clinical examination and diagnosis leading to the treatment plan.
- Informed consent from the patient acknowledging the nature and purpose of the denture.
- Records of the materials used and the fabrication process of the denture.
Billing Considerations
When billing for D5286, ensure that the procedure is not performed more frequently than allowed by the patient's insurance plan. Common modifiers may include those indicating the specific quadrant treated. Verify coverage with the insurance provider, as some plans may have specific limitations or require pre-authorization for removable partial dentures.
Related CDT Codes
Frequently Asked Questions
The code includes one piece of resin for the denture, along with all retentive/clasping materials, rests, and teeth for one quadrant.
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