How often can D5867 be billed?

Frequency depends on the wear and tear of the attachment parts and the patient's specific insurance policy. It's essential to document clinical necessity.

Are there specific brands of attachments covered under this code?

D5867 is not brand-specific, but documentation should include the type and brand of the attachment part used for transparency and insurance purposes.

Can D5867 be used for fixed prosthodontics?

No, D5867 is specifically for removable prosthodontic services involving semi-precision or precision attachments.

Is prior authorization required for billing D5867?

This depends on the patient's insurance plan. It's advisable to check with the insurer to determine if prior authorization is necessary.

D5867

Replacement Part for Attachment - CDT Code Guide

Prosthodontics, removable/Other Removable Prosthetic Services

Overview

CDT Code D5867 pertains to the replacement of a replaceable part of a semi-precision or precision attachment, per attachment. This procedure is crucial in the maintenance and functionality of removable prosthodontic appliances. Typically, these attachments are used in partial dentures to enhance retention and stability. Over time, the components may wear out or become damaged, necessitating replacement to ensure the prosthesis continues to function effectively. Dental professionals should be familiar with this code to provide optimal care and maintain the longevity of the prosthetic devices.

When to Use This Code

When a component of a semi-precision attachment in a partial denture is worn out
If a precision attachment in a removable prosthesis is damaged and needs replacement
During routine maintenance of a removable prosthodontic appliance where parts need updating
When a patient reports decreased retention or stability of their prosthesis due to worn attachments
In cases where the attachment has been lost and needs to be replaced to restore function

Documentation Requirements

Detailed description of the attachment part being replaced
Clinical notes on the condition of the existing attachment
Patient consent for the replacement procedure
Documentation of the type and brand of the new attachment part
Photographic evidence of the need for replacement, if applicable
Invoice or receipt for the replacement part used

Billing Considerations

When billing for D5867, ensure the frequency of replacements is justified by clinical necessity. Common modifiers may include those indicating the specific quadrant or arch. Insurance plans may have specific guidelines on the coverage of attachment replacements, so verifying patient benefits beforehand is crucial.

Related CDT Codes

D5866 D5875 D5110 D5213

Frequently Asked Questions

Replaceable parts include any components of the attachment system that can be removed and replaced without altering the entire prosthesis.

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