Obturator Prosthesis, Surgical - CDT Code Guide
Overview
CDT Code D5931 pertains to the obturator prosthesis, surgical, which is a critical component in maxillofacial prosthetics. This temporary prosthesis is typically used following surgical or traumatic loss of parts of the maxillary bones and surrounding structures. It serves as an immediate solution to restore function and aesthetics during the healing phase, which can last approximately six months. The procedure involves the insertion of a temporary device that may or may not include replacement teeth, depending on the dentist's preference and the specifics of the surgical procedure. Frequent adjustments and revisions are often necessary as the surgical site heals and changes. In some cases, further surgical interventions may necessitate a new obturator, especially if the defect size changes significantly after pathology reports.
When to Use This Code
- After surgical removal of maxillary bone due to cancer
- Following traumatic injury to the maxillary region
- During the healing phase post-maxillary surgery
- When immediate prosthetic rehabilitation is required
- In cases where temporary restoration of oral function is needed
Documentation Requirements
- Detailed surgical report outlining the extent of maxillary loss
- Pathology report if applicable
- Clinical notes on the necessity of the obturator
- Patient consent forms for prosthetic treatment
- Progress notes on healing and any revisions made
- Photographic evidence of pre- and post-surgical conditions
Billing Considerations
When billing for D5931, it is important to note that frequent revisions may be necessary, which can affect billing frequency. Insurance coverage may vary, and pre-authorization is often recommended. Common modifiers include those indicating bilateral procedures or additional surgical sites. Ensure documentation supports the medical necessity of the obturator.
Related CDT Codes
Frequently Asked Questions
The primary purpose is to temporarily restore oral function and aesthetics following the surgical or traumatic loss of maxillary structures.
Need help with dental coding?
Our AI-powered assistant can answer your CDT code questions instantly.