How long is an interim obturator typically used?

It is used until the surgical site has fully healed and a definitive obturator can be made, usually several months.

Can an interim obturator be modified?

Yes, it often requires modifications to accommodate changes in the mouth during healing.

Is D5936 covered by insurance?

Coverage depends on the insurance plan, but it is often covered when medically necessary and properly documented.

What should be included in the documentation for D5936?

Include surgical details, healing status, impressions, and any modifications to the prosthesis.

D5936

Obturator Prosthesis, Interim - CDT Code Guide

Maxillofacial Prosthetics/Other Removable Prosthetic Services

Overview

CDT code D5936 refers to an interim obturator prosthesis, a temporary dental device used after the initial healing phase following surgical resection of the maxillae. This prosthesis is crucial for patients who have undergone surgery to remove part or all of the maxilla, as it helps close the defect area and often replaces missing teeth and tissue structures. Unlike the surgical obturator, which is used immediately after surgery, the interim obturator is crafted once the surgical site has stabilized, ensuring a better fit and function. It is designed to accommodate changes in the mouth as healing progresses and may require modifications during subsequent dental treatments.

When to Use This Code

Following surgical resection of the maxillae after initial healing
When replacing a surgical obturator with a more stable interim solution
To facilitate oral function and aesthetics during the healing period
In cases where further surgical revisions are not planned
When there is a need to replace missing teeth and tissue temporarily

Documentation Requirements

Detailed surgical report outlining the resection
Clinical notes on the healing status of the surgical site
Impressions and measurements of the defect area
Documentation of any modifications made to the prosthesis
Patient consent and treatment plan outlining interim use

Billing Considerations

When billing for D5936, consider that this code is typically used once per surgical site during the healing phase. Ensure that the procedure is documented thoroughly to justify the need for an interim prosthesis. Be aware of any insurance-specific guidelines regarding the frequency of prosthesis replacements and modifications. Common modifiers may include those indicating the stage of treatment or specific patient conditions.

Related CDT Codes

D5931 D5932 D5933 D5934 D5935

Frequently Asked Questions

A surgical obturator is used immediately after surgery, while an interim obturator is used after initial healing to provide a better fit.

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