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We use code D5865 for a complete mandibular overdenture, but it only pays about $1000. Our cost is about $4000. Is there a different code we are supposed to use or is there an additional code that I should use?

We use code D5865 for a complete mandibular overdenture, but it only pays about $1000. Our cost is about $4000. Is there a different code we are supposed to use or is there an additional code that I should use?

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Posted by Admin

Asked on March 5, 2015 12:39 pm

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The ADA gives instructions on coding for overdenture. It's not only the overdenture but also each precision attachment that you would code for. Hope that helps!
https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/publications/cdt/cdt_overdenturecodingguidance_naturaltoothborneandimplantborneprostheses_2020nov.pdf

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Posted by Julia

Answered on March 23, 2023 1:17 pm

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Without knowing the specifics, yes, D5863 is the correct code for overdenture- complete mandibular regardless of reimbursement. Now if you are performing other procedures during this time those may be coded out along with the prosthetic service. It is important to review the documentation and code for all services provided.

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Posted by Admin

Answered on March 6, 2015 12:39 pm

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