Ocular Prosthesis, Interim - CDT Code Guide
Overview
CDT Code D5923 refers to the fabrication of an interim ocular prosthesis, which is a temporary eye replacement often used after surgery or trauma resulting in the loss of an eye. This prosthesis is typically made from clear acrylic resin and serves as a placeholder until a more permanent, aesthetic ocular prosthesis can be created. The interim prosthesis does not aim to restore the cosmetic appearance but rather to maintain the space and support healing. This procedure is crucial in the initial stages following enucleation or evisceration to ensure proper anatomical conformation and to aid in the psychological adjustment of the patient.
When to Use This Code
- Following surgical removal of an eye due to trauma or disease
- During the healing period post-enucleation or evisceration
- When a patient is awaiting a custom aesthetic ocular prosthesis
- To maintain the anatomical space and prevent socket contraction
- In cases where immediate aesthetic restoration is not feasible
Documentation Requirements
- Detailed patient history and diagnosis leading to eye loss
- Clinical notes on the surgical procedure performed
- Description of the interim prosthesis fabrication process
- Patient consent forms for the interim prosthesis
- Follow-up care instructions and future prosthesis planning
- Photographic documentation of the ocular area pre and post-procedure
Billing Considerations
When billing for D5923, it's important to note that this code is typically used once per eye loss event. Insurance coverage may vary, and pre-authorization is often required. Common modifiers may include those indicating laterality (e.g., LT for left eye, RT for right eye). Ensure that the documentation supports the medical necessity of the interim prosthesis.
Related CDT Codes
Frequently Asked Questions
The interim ocular prosthesis serves as a temporary solution to maintain the anatomical space and support healing after eye loss, until a permanent prosthesis can be made.
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