Mandibular Partial Denture Flexible Base - CDT Code Guide
Overview
CDT code D5226 refers to the fabrication and delivery of a mandibular partial denture with a flexible base. This procedure is designed to replace missing teeth in the lower jaw, using a flexible material that provides comfort and adaptability to the patient's mouth. The flexible base includes all necessary components such as retentive and clasping materials, rests, and artificial teeth. This type of denture is particularly beneficial for patients who require a more comfortable fit or have specific anatomical considerations that make traditional rigid dentures unsuitable. Dental professionals often recommend this option for patients seeking a balance between functionality and comfort, especially when dealing with sensitive oral tissues or when a more aesthetic outcome is desired.
When to Use This Code
- When a patient requires a partial denture for the lower jaw with enhanced comfort.
- In cases where the patient has sensitive oral tissues that may not tolerate rigid bases.
- When aesthetics and a natural appearance are a priority for the patient.
- For patients who have experienced discomfort with traditional rigid partial dentures.
- In situations where a flexible base can provide better adaptability to the patient's oral anatomy.
Documentation Requirements
- Detailed patient records including oral examination and diagnosis.
- Documentation of the patient's dental history and previous prosthetic use.
- Clinical notes on the selection of a flexible base over other materials.
- Impressions and models used in the fabrication of the denture.
- Patient consent forms acknowledging understanding of the procedure and material used.
- Post-delivery care instructions and follow-up appointments.
Billing Considerations
When billing for D5226, ensure that the procedure is not being performed more frequently than allowed by the patient's insurance plan. Common modifiers may include those indicating the arch or quadrant involved. It's important to verify coverage for flexible base dentures, as some insurance plans may have specific exclusions or require prior authorization.
Related CDT Codes
Frequently Asked Questions
A flexible base denture is made from a softer, more adaptable material that offers increased comfort and is often more aesthetically pleasing compared to traditional rigid dentures.
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