Is D5924 covered by insurance?

Coverage for D5924 varies by insurance provider and plan. It's important to verify benefits and obtain prior authorization if required.

What materials are used for cranial prostheses?

Cranial prostheses are typically made from biocompatible materials such as titanium or medical-grade polymers designed to integrate with the body.

Can D5924 be used for cosmetic purposes?

D5924 is primarily used for medical necessity, such as protecting the brain and restoring skull integrity, rather than cosmetic enhancement.

Who performs the cranial prosthesis procedure?

The procedure is typically performed by a neurosurgeon or a craniofacial surgeon, often in collaboration with a maxillofacial prosthodontist.

D5924

Cranial Prosthesis - CDT Code Guide

Maxillofacial Prosthetics/Other Removable Prosthetic Services

Overview

CDT code D5924 refers to the cranial prosthesis, a specialized procedure involving the replacement of a portion of the skull with a biocompatible implant. This procedure is typically necessary following trauma, surgical removal of bone due to disease, or congenital defects. The cranial prosthesis serves as a permanent solution to protect the brain and restore the natural contour of the skull. Dental professionals involved in maxillofacial prosthetics may encounter this code when collaborating with surgical teams in complex craniofacial reconstructions.

When to Use This Code

Following a craniectomy where a portion of the skull is removed due to trauma or disease.
In cases of congenital skull defects requiring structural correction.
When a patient has undergone surgical removal of skull bone due to cancer.
During reconstructive surgery post-traumatic brain injury.
For patients needing aesthetic restoration after skull deformity.

Documentation Requirements

Detailed surgical report outlining the need for the cranial prosthesis.
Pre-operative and post-operative imaging studies.
Patient's medical history indicating the condition necessitating the procedure.
Description of the prosthesis material and its biocompatibility.
Consent forms signed by the patient or legal guardian.
Follow-up care plan and any rehabilitation services required.

Billing Considerations

When billing for D5924, ensure that the procedure is medically necessary and well-documented. Check with the patient's insurance provider for coverage specifics, as some plans may have restrictions or require prior authorization. Be aware of any frequency limitations and use appropriate modifiers if the procedure is part of a larger surgical plan. Coordination with medical billing may be necessary due to the interdisciplinary nature of the procedure.

Related CDT Codes

D5931 D5932 D5933 D5934 D5935

Frequently Asked Questions

A cranial prosthesis is an artificial implant used to replace a portion of the skull that has been removed due to trauma, disease, or congenital defects.

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