Pediatric Partial Denture, Fixed - CDT Code Guide
Overview
CDT code D6985 refers to a pediatric partial denture, fixed, primarily used for aesthetic purposes. This prosthesis is designed to replace missing teeth in children, providing a fixed solution that enhances the appearance and function of a child's smile. Typically, this procedure is considered when a child has lost one or more teeth due to trauma, decay, or congenital absence, and a fixed solution is preferred over removable options. The fixed partial denture is custom-made to fit the child's dental arch and is securely attached to the adjacent teeth or dental implants, ensuring stability and comfort.
In clinical practice, the use of a fixed partial denture in pediatric patients requires careful planning and consideration of the child's oral development. The prosthesis not only restores the aesthetic appearance but also helps maintain proper spacing for permanent teeth, supporting overall oral health. Dental professionals must evaluate the child's dental and medical history, growth patterns, and specific needs to determine the suitability of this treatment.
When to Use This Code
- When a child has lost one or more anterior teeth due to trauma.
- In cases of congenital absence of teeth where a fixed solution is preferred.
- When a child requires aesthetic improvement and functional restoration of missing teeth.
- To maintain space for permanent teeth in a growing child.
- When a removable partial denture is not suitable or desired by the patient or guardian.
Documentation Requirements
- Detailed patient history and clinical examination notes.
- Radiographic evidence supporting the need for a fixed partial denture.
- Documentation of the child's growth and development considerations.
- Informed consent from the parent or guardian outlining the procedure and its benefits.
- Records of the prosthesis design and materials used.
- Follow-up care instructions and maintenance plan.
Billing Considerations
When billing for D6985, it's important to note any frequency limitations set by the insurance provider, as some may restrict the number of prosthetic procedures within a certain timeframe. Common modifiers may include those indicating the specific tooth or quadrant involved. Insurance considerations often require pre-authorization, especially for pediatric cases, to ensure coverage. Accurate documentation and justification for the procedure are crucial for successful claims.
Related CDT Codes
Frequently Asked Questions
Coverage for D6985 varies by insurance plan. Pre-authorization is often required, and coverage may depend on the medical necessity and specific policy terms.
Need help with dental coding?
Our AI-powered assistant can answer your CDT code questions instantly.