Speech Aid Prosthesis, Adult - CDT Code Guide
Overview
CDT Code D5953 refers to the fabrication of a speech aid prosthesis for adults, commonly used in cases involving cleft palate. This prosthesis serves to improve speech by sealing off palatal clefts or assisting an incompetent soft palate, thereby achieving velopharyngeal competency. It is a definitive prosthesis intended for long-term use, crafted with precise materials and techniques. Often, this procedure is integrated with precision attachments in crown work on maxillary teeth to enhance aesthetics. The prosthesis is typically fabricated when no further growth is anticipated, ensuring a stable and effective solution for speech improvement.
When to Use This Code
- Adult patients with a cleft palate requiring speech improvement.
- Cases where a palatal cleft or fistula needs obturation.
- Patients with an incompetent soft palate affecting speech.
- When long-term prosthetic solutions are needed post-growth.
- In conjunction with crown work for improved aesthetics in maxillary teeth.
Documentation Requirements
- Detailed patient history and diagnosis of cleft palate or related conditions.
- Clinical notes on the necessity of a speech aid prosthesis.
- Documentation of the materials and techniques used in fabrication.
- Records of any associated crown work or precision attachments.
- Patient consent forms and treatment plans.
- Follow-up care and adjustment notes post-prosthesis placement.
Billing Considerations
When billing for D5953, it's important to note that this is a specialized procedure often requiring pre-authorization from insurance providers. Frequency limitations may apply, and it's crucial to document the medical necessity thoroughly. Common modifiers may include those indicating the specific quadrant or arch involved. Coordination with insurance for coverage of associated crown work is also advisable.
Related CDT Codes
Frequently Asked Questions
The primary purpose is to improve speech by addressing issues related to cleft palate or an incompetent soft palate.
Need help with dental coding?
Our AI-powered assistant can answer your CDT code questions instantly.