D5000 – D5899 Prosthodontics, Removable
By Terry Kelly, D.M.D.
The Removable Prosthodontics category of service describes procedures which replace missing dentition in partially or completely edentulous patients. As a result, the stability and retention of a removable prosthesis may be dependent on both hard and soft tissue support, which may also include dental implants. Many of the materials used in the fabrication of these prostheses have particular characteristics that are described in the code. These characteristics identify their uniqueness and create specific instances where they should be used.
In addition, because most of the materials used can be modified or repaired for an otherwise well-fitting prosthesis, there is a significant portion of this code set which describes various repairs, relines, and adjustments which can be incorporated to maintain or modify a prosthesis when changes occur to the supporting structures. It is important to note that all procedure codes in this category are inherently based on either a partial or complete denture. Moreover, most of the procedures will specifically designate maxillae or mandible in the nomenclature of the code.
The Glossary of Prosthodontics Terms from the Academy of Prosthodontics contains descriptors for all removable prosthodontic procedures, and is an excellent resource for comprehensive definitions of prosthodontic procedures. It is available at www.academyofprosthodontics.org.
Complete Denture: A removable prosthesis that replaces an entire arch of dentition and associated structures.
Partial Denture: A removable prosthesis that replaces a portion of missing dentition and associated structures.
Immediate Partial or Complete Denture: A removable prosthesis that is specifically designed to replace a portion or all of the missing dentition in an arch, which is inserted immediately following extraction of teeth. Adaptation of the prosthesis frequently involves placement of a soft lining material at insertion, which is included as part of the routine delivery of care for these procedure codes. Subsequent visits which may include additional adjustments or relines should be coded as such. It is important to note that an immediate denture is only applicable as a coded procedure for the initial insertion appointment. After that, for purposes of adjustments, repairs, or relines, the correct code would either be a partial or complete denture.
Overdenture: A removable prosthesis that covers and is partially supported by natural teeth, roots, and/or dental implants.
Prosthesis: An artificial replacement of an absent part of the human body; designed to restore form and function
The codes describing repairs to both partial and complete dentures now specify in the nomenclature whether the repair occurs in the maxillae or mandible, following the existing format for codes in this section. These codes, added in CDT 2018, specifically identify repairs to complete denture bases, as well as repairs to resin and cast frameworks for partial dentures. They replace the following deleted codes: D5510, D5610, and D5620.
Diagnosis Codes – ICD-10-CM
The CDT to ICD tables in Appendix 1 provide appropriate guidance on linkages between removable Prosthodontics procedure codes and diagnosis codes. This chapter does not contain supplemental information on this topic.
CODING SCENARIO #1
Modified Mandibular Complete Denture
A patient presents with an existing mandibular complete denture which needs to be modified following placement of two implant fixtures in the anterior mandible. Following surgery the denture is relieved in the areas of implant placement, and a soft liner or tissue conditioner is placed to re-adapt the denture base.
How would you code this procedure?
D5875 modification of removable prosthesis following implant surgery
D5851 tissue conditioning, mandible
• D5875 is used to describe the procedure which modifies an existing removable prosthesis following implant surgery.
• In the event that a completely new mandibular overdenture will be fabricated with an implant abutment/attachment such as a locator, then the following codes in the Implant Services category would apply:
D6111 implant/abutment supported removable denture for edentulous arch – mandible
D6052 semi-precision attachment abutment
(Report each abutment attachment assembly separately.)