Is pre-authorization required for D8091?

Yes, due to the complexity and cost, pre-authorization is often required by insurance providers.

Can D8091 be used for minor jaw adjustments?

No, D8091 is intended for comprehensive treatment involving significant surgical intervention.

Are there any age restrictions for using D8091?

While there are no specific age restrictions, the procedure is typically used for patients whose jaw growth is complete.

How does D8091 affect treatment duration?

The inclusion of surgery can extend the overall treatment time, as it involves both pre- and post-surgical orthodontic phases.

D8091

Ortho with Orthognathic Surgery - CDT Code Guide

Orthodontics

Overview

CDT code D8091 refers to comprehensive orthodontic treatment that includes orthognathic surgery. This procedure is typically used in cases where traditional orthodontic methods alone are insufficient to correct severe dental and skeletal discrepancies. Orthognathic surgery involves surgical intervention to correct jaw irregularities, which can improve both function and aesthetics. This code is essential for cases where patients require a combination of braces and surgical procedures to achieve optimal oral health outcomes. It is often utilized in scenarios involving severe malocclusion, jaw misalignment, or congenital defects affecting the jaw structure.

When to Use This Code

Severe malocclusion requiring both orthodontic treatment and jaw surgery.
Cases of jaw misalignment that cannot be corrected with braces alone.
Patients with congenital jaw defects needing comprehensive treatment.
Situations where functional and aesthetic improvements are necessary.
Orthodontic treatment plans that include surgical intervention for best results.

Documentation Requirements

Detailed treatment plan outlining the need for orthognathic surgery.
Pre-operative and post-operative orthodontic records.
Surgical reports from the oral surgeon involved.
Patient consent forms for both orthodontic and surgical procedures.
Progress notes documenting treatment milestones and outcomes.
Insurance pre-authorization documentation, if applicable.

Billing Considerations

When billing for D8091, it is crucial to ensure that the treatment plan justifies the need for both orthodontic and surgical interventions. Insurance companies may require pre-authorization due to the complexity and cost of the procedure. Be aware of any frequency limitations and use appropriate modifiers to indicate the comprehensive nature of the treatment. Coordination with the surgical team is essential for accurate billing and reimbursement.

Related CDT Codes

D8080 D8210 D8680 D8690 D8703

Frequently Asked Questions

D8091 includes both orthodontic treatment and orthognathic surgery, while standard codes typically cover only braces or aligners.

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