Overdenture Complete Maxillary - CDT Code Guide
Overview
CDT code D5863 refers to the procedure of fabricating and fitting a complete maxillary overdenture. This type of denture is designed to fit over existing teeth or dental implants, providing improved stability and function compared to traditional dentures. Typically, this procedure is indicated for patients who have lost all their upper teeth but have retained some natural tooth roots or implants that can support the overdenture. The process involves taking precise impressions, creating a custom-fitted denture, and ensuring proper alignment and comfort for the patient. Overdentures can significantly enhance a patient's ability to chew and speak, and they often improve the overall quality of life by offering a more secure fit.
When to Use This Code
- Patient has lost all upper teeth but retains some tooth roots for support.
- Patient has dental implants in the maxillary arch that can support an overdenture.
- Patient requires improved stability and retention compared to conventional dentures.
- Patient experiences discomfort or instability with traditional complete dentures.
- Patient seeks enhanced masticatory function and speech clarity.
Documentation Requirements
- Detailed patient history and clinical examination notes.
- Radiographic evidence supporting the need for an overdenture.
- Documentation of existing tooth roots or implants for support.
- Impression records and measurements for denture fabrication.
- Patient consent forms and treatment plan agreements.
- Follow-up visit notes to ensure proper fit and function.
Billing Considerations
When billing for D5863, ensure that the procedure is not performed more frequently than allowed by the patient's insurance plan, as many insurers have specific frequency limitations for prosthetic services. Use appropriate modifiers if the procedure is part of a more comprehensive treatment plan. Verify coverage with the patient's insurance provider, as some plans may require pre-authorization for overdentures.
Related CDT Codes
Frequently Asked Questions
An overdenture is supported by existing teeth or implants, offering more stability, while a traditional denture rests solely on the gums.
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