Is pre-authorization required for this procedure?

Pre-authorization may be required depending on the patient's insurance policy and the extent of the repair needed.

How long does the repair process usually take?

The repair process can typically be completed within a single dental visit, but complex cases may require additional time.

Can this code be used for repairs on complete dentures?

No, D5630 is specific to partial dentures. Different codes apply to complete denture repairs.

How often can this procedure be billed?

Frequency limitations depend on the insurance policy, but typically repairs are covered as needed when justified by clinical necessity.

D5630

Repair/Replace Retentive Materials - CDT Code Guide

Prosthodontics, removable/Repairs to Partial Dentures

Overview

CDT Code D5630 is used for the repair or replacement of broken retentive or clasping materials on a per tooth basis. This procedure is essential in maintaining the functionality and comfort of removable partial dentures. Typically, this code is utilized when a patient presents with a partial denture that has a broken clasp or retentive element, which compromises the stability and retention of the denture. The repair process involves assessing the damage, selecting appropriate materials, and executing the repair to restore the denture's effectiveness. This code is crucial for dental professionals as it ensures patients receive the necessary repairs to maintain oral health and denture functionality.

When to Use This Code

A patient presents with a broken clasp on their partial denture.
The retentive element of a partial denture is damaged and needs replacement.
During a routine check-up, a broken retentive material is identified on a partial denture.
A patient reports discomfort due to a damaged clasp on their partial denture.
A partial denture is not fitting properly due to a broken retentive component.

Documentation Requirements

Detailed description of the damage to the retentive/clasping materials.
Clinical notes on the necessity of the repair or replacement.
Materials used for the repair or replacement documented.
Before and after photos of the partial denture, if applicable.
Patient consent for the repair procedure.
Billing records indicating the specific tooth involved.

Billing Considerations

When billing for D5630, it is important to note any frequency limitations set by the patient's insurance provider. Common modifiers may include those indicating the specific quadrant or arch involved. Insurance considerations often require pre-authorization for extensive repairs, and documentation should clearly justify the necessity of the procedure to avoid claim denials.

Related CDT Codes

D5510 D5520 D5640 D5650 D5660

Frequently Asked Questions

Common materials include dental alloys and acrylic resins, chosen based on the specific needs of the repair.

Need help with dental coding?

Our AI-powered assistant can answer your CDT code questions instantly.

Try CDT Code Lookup Browse All CDT Codes