D5992

Adjust Maxillofacial Prosthetic Appliance - CDT Code Guide

Maxillofacial Prosthetics/Other Removable Prosthetic Services

Overview

CDT code D5992 pertains to the adjustment of maxillofacial prosthetic appliances. This procedure is crucial for patients who have undergone significant oral or facial surgery and require prosthetic devices to restore function and aesthetics. Adjustments may be necessary due to changes in the patient's anatomy, discomfort, or wear and tear of the appliance. Dental professionals perform these adjustments to ensure optimal fit and function, enhancing the patient's quality of life. Typical scenarios include post-surgical adjustments, modifications due to weight loss or gain, or routine maintenance to address wear.

When to Use This Code

  • Post-surgical adjustments to maxillofacial prosthetics
  • Routine maintenance for wear and tear of the appliance
  • Adjustments due to anatomical changes like weight loss or gain
  • Addressing patient discomfort or fit issues
  • Modifications following dental or facial trauma

Documentation Requirements

  • Detailed patient history and reason for adjustment
  • Clinical notes describing the adjustment procedure
  • Photographic evidence of the prosthetic before and after adjustment
  • Patient consent forms for the procedure
  • Documentation of any complications or additional procedures performed
  • A report justifying the necessity of the adjustment

Billing Considerations

When billing for D5992, ensure that the procedure is not performed too frequently as it may raise red flags with insurance providers. Use appropriate modifiers if the adjustment is part of a larger treatment plan. Verify with the patient's insurance for coverage specifics, as some plans may have limitations on prosthetic adjustments.

Related CDT Codes

Frequently Asked Questions

Adjustments are made to ensure the appliance fits properly, functions optimally, and provides comfort to the patient.

Source: CDT 2023 © American Dental Association

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