PROSTHODONTICS - American College of Prosthodontists

70 Parameters of Care Tupac et alFacial Moulage, Sectional [D5911 CDT-2005]Facial Prosthesis, ReplacementMandibular Resection/Reconstruction Prosthesis [21081 CPT-2005]Maxillofacial Stabilization Prosthesis [21089 CPT-2005]Nasal Prosthesis [21087 CPT-2005]Obturator Prosthesis, Definitive [21080 CPT-2005]Obturator Prosthesis, Interim [21079 CPT-2005]Obturator Prosthesis, Surgical [21076 CPT-2005]Maxillary resection, reconstruction prosthesisOrbital Prosthesis [21077 CPT-2005]Intraoral prosthesis [21081 CPT-2005]Parameter Guidelines: Composite Resection DefectICD-9 CodesRefer to subparameters 11A, 11B, 11C, 11E, 11G, 11H.A. Indications for care1. Facial soft-tissue deformity resulting from skin, muscle, and connective tissue loss2. Facial hard-tissue deformity from loss of bone, teeth, and cartilage3. Loss of sensory organ (eye) resulting in blindness4. Loss of sensory organ (nose) resulting in loss of smell5. Oral tissue loss (hard and soft tissues), resulting in reduced oral competency, decreased mastication,disrupted speech, dysphasia, and facial reflux during eating and swallowing6. Exposure of nasal, sphenoid, and frontal sinuses7. Compromised speech resonance with increased nasality8. Communication of oral-nasal-facial cavities9. Loss of patient’s self-esteem10. Professional referralsB. Therapeutic goals1. Restoration of facial form2. Restoration of ocular form3. Restoration of oral competence with reduction of oral and facial reflux4. Substitution for dento-alveolar structures and facial structures5. Improvement of nasal-oral-facial cavity separation6. Improvement in self-esteem and quality of life7. Improvement in deglutition and mastication8. Restoration of speech, improved resonance, and reduced nasality9. Restoration of sinus partition to improve normal humidity10. Reduction of mucous crusting and control of normal discharge of bodily fluidsC. Risk factors affecting quality of treatment (severity factors that increase risk and the potential forknown complications)1. Status of existing disease: contiguous, local, or systemic2. Size and location of defect3. Number of sensory structures normally found within defect4. Inability to speak and communicate5. Complications from alterations in normal anatomical soft-tissue form and bony support6. Local wound changes, friable tissues, scar tissue, hemorrhage7. Compromise from functional rehabilitation to form rehabilitation8. Maintenance of nasal and oral airway9. Incomplete surgical reconstruction10. Preexisting systemic conditions11. Psychosocial factors12. Scarring2010 CDEL Re-recognition of the Specialty Report 110 of 279