Maxillary Guidance Prosthesis - CDT Code Guide
Overview
CDT Code D5909 refers to the maxillary guidance prosthesis with a guide flange, a specialized dental appliance used in maxillofacial prosthetics. This prosthesis is designed to assist patients who have undergone surgical resection of the maxilla, often due to cancer or trauma, by guiding the mandible into proper occlusion. The guide flange helps in stabilizing the jaw and improving the patient's ability to chew and speak. This procedure is crucial for patients requiring rehabilitation of their oral function and aesthetics post-surgery. Dental professionals use this prosthesis to ensure that the remaining oral structures are supported and to facilitate the patient's adaptation to changes in their oral cavity.
When to Use This Code
- Post-surgical rehabilitation for maxillary resection patients
- Patients with significant maxillary defects affecting occlusion
- Cases where mandibular guidance is necessary for proper jaw alignment
- Patients experiencing difficulty in mastication due to maxillary defects
- Rehabilitation of oral function in maxillofacial trauma cases
Documentation Requirements
- Detailed patient medical and dental history
- Clinical notes on the extent of maxillary resection or defect
- Impressions and measurements of the oral cavity
- Treatment plan outlining the need for a guide flange
- Progress notes documenting patient adaptation and prosthesis adjustments
- Photographic evidence of the prosthesis in place
Billing Considerations
When billing for D5909, it is important to note any frequency limitations imposed by insurance providers. This code may require prior authorization due to its specialized nature. Common modifiers include those indicating the specific quadrant or arch involved. Dental professionals should verify coverage with the patient's insurance, as maxillofacial prosthetics can sometimes fall under medical rather than dental benefits.
Related CDT Codes
Frequently Asked Questions
The primary purpose is to assist in guiding the mandible into proper occlusion and to aid in the rehabilitation of oral function following maxillary resection.
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