How often can D5411 be billed?

Frequency depends on the patient's insurance policy; typically, adjustments are covered within a specific timeframe after initial denture placement.

Can D5411 be used for partial dentures?

No, D5411 is specifically for complete mandibular dentures. Use appropriate codes for partial denture adjustments.

Is patient consent required for a denture adjustment?

Yes, obtaining patient consent is a standard practice before performing any dental procedure.

What should be included in the adjustment procedure notes?

Include details of the patient's initial complaints, the specific adjustments made, and the patient's response post-adjustment.

D5411

Adjust Complete Denture Mandibular - CDT Code Guide

Prosthodontics, removable/Adjustments to Dentures

Overview

CDT Code D5411 pertains to the adjustment of a complete mandibular denture. This procedure is essential when a patient experiences discomfort, improper fit, or functional issues with their lower denture. Adjustments are typically necessary after initial placement as the oral tissues adapt, or due to changes in the patient's oral anatomy over time. Dental professionals perform this procedure to ensure optimal fit and comfort, enhancing the patient's ability to chew and speak effectively. The adjustment process may involve reshaping the denture base, adjusting occlusion, or relieving pressure points.

When to Use This Code

When a patient reports discomfort or pain from their mandibular denture.
If there are signs of denture instability or frequent dislodgement.
Following significant weight loss or other changes in oral anatomy.
After initial denture placement as part of routine follow-up care.
When there are visible pressure sores or irritation in the oral tissues.

Documentation Requirements

Detailed notes on the patient's symptoms and complaints.
Clinical observations of the denture fit and any visible oral tissue changes.
Description of the specific adjustments made to the denture.
Patient's response to the adjustment and any follow-up recommendations.
Date of service and practitioner performing the adjustment.
Patient consent for the procedure.

Billing Considerations

When billing for D5411, it's important to note that adjustments may be limited in frequency by insurance providers, often covered only after a certain period post-placement. Modifiers may be necessary if the adjustment is part of a larger treatment plan. Verify with the patient's insurance for specific coverage details and any pre-authorization requirements.

Related CDT Codes

D5410 D5421 D5422 D5130 D5140

Frequently Asked Questions

D5410 refers to adjustments for maxillary dentures, while D5411 is specific to mandibular dentures.

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