Can the patient remove the fixed appliance?

No, fixed appliances are designed to remain in place and cannot be removed by the patient.

How long does a patient typically wear a fixed appliance?

The duration varies but typically ranges from several months to a year, depending on the habit's severity and patient compliance.

Are there any risks associated with fixed appliance therapy?

Risks are minimal but can include discomfort, irritation, or difficulty in speech initially. Regular follow-ups help mitigate these issues.

Is fixed appliance therapy covered by insurance?

Coverage varies by insurance plan; it's important to verify with the provider beforehand.

D8220

Fixed Appliance Therapy - CDT Code Guide

Orthodontics/Minor Treatment to Control Harmful Habits

Overview

CDT Code D8220 refers to fixed appliance therapy, a treatment used in orthodontics to address harmful oral habits such as thumb sucking and tongue thrusting. These appliances are fixed, meaning they cannot be removed by the patient, ensuring continuous therapeutic effect. This treatment is crucial for preventing dental and skeletal malformations that can arise from persistent harmful habits. Typically, fixed appliance therapy involves the use of devices like palatal cribs or habit breakers, which are custom-fitted to the patient's mouth. These appliances are designed to discourage the habit by creating a physical barrier, thus promoting healthier oral development.

When to Use This Code

When a child has a persistent thumb sucking habit beyond the age of 4-5 years.
In cases where tongue thrusting is causing anterior open bite or speech issues.
When interceptive orthodontic treatment is necessary to prevent malocclusion.
For patients who have not responded to other habit-breaking interventions.
When a fixed solution is preferred over removable appliances for compliance reasons.

Documentation Requirements

Detailed patient history indicating the presence of a harmful oral habit.
Clinical notes describing the specific habit and its impact on oral health.
Photographic evidence or radiographs showing the need for intervention.
A treatment plan outlining the use of the fixed appliance and expected outcomes.
Patient consent form acknowledging understanding of the appliance's purpose and permanence.
Regular follow-up notes to monitor progress and adjust treatment as necessary.

Billing Considerations

When billing for D8220, it's important to note that some insurance plans may have frequency limitations or may not cover habit-breaking appliances. Common modifiers might include those indicating the specific quadrant or arch treated. It's advisable to verify coverage with the patient's insurance provider before proceeding with treatment to avoid unexpected costs.

Related CDT Codes

D8210 D8670 D8080 D8090 D8690

Frequently Asked Questions

The main purpose is to prevent or correct harmful oral habits that can lead to dental or skeletal issues.

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