PROSTHODONTICS - American College of Prosthodontists

December 2005, Supplement, Volume 14, Number 4 101substantiated by documentation in the dental record. Procedural codes listed throughout this sectionserve as a guide, which may be applicable to the treatment performed or management modality chosen.These may not be the most recent, applicable, or acceptable codes. Some dental/medical insuranceproviders have billing conventions unique to their organizations. It is the provider’s responsibility to beaware of these unique situations.Current Procedural Terminology (CPT), the recognized codes for dental/medical billing, are revisedyearly and must be reviewed and updated annually to ensure accuracy. The recent codes are acceptedby dental/medical insurance providers and should be obtained from the current year’s version of theAmerican Medical Association (AMA) CPT Manual. Current Procedural Terminology C○ 2005 American MedicalAssociation. All rights reserved.Current Dental Terminology (CDT) codes, the recognized codes for dental/medical billing, are revisedevery 3 years (previously every 5 years) and should be reviewed and updated whenever the most recentversion of the American Dental Association (ADA) CDT manual is published. Current Dental Terminology C○2002, 2004 American Dental Association. All rights reserved.Parameter Guidelines: Terminal DentitionICD-9-CMUse additional codes to identify cause of Partial Edentulism (525.10–525.19).1. 525.50 Partial edentulism, unspecified2. 525.51 Partial edentulism, Class I3. 525.52 Partial edentulism, Class II4. 525.53 Partial edentulism, Class III5. 525.54 Partial edentulism, Class IV6. 52x.xx Completely Dentate (codes under submission)The specific determinants of the PDI for Partial Edentulism can be found in the ICD-9-CM codes521–525; some examples are listed below:306.8 Other specified psychophysiological malfunction: Bruxism, Teeth grinding521 Diseases of hard tissues of teeth522 Diseases of pulp and periapical tissues523 Gingival and periodontal diseases524 Dentofacial anomalies, including malocclusion525 Other diseases and conditions of the teeth and supporting structures873.6 Tooth [broken] uncomplicated873.7 Tooth [broken] complicatedA. Indications for care1. Inadequate mastication2. Pain/discomfort3. Inadequate esthetics4. Inadequate support of TM joint and orofacial muscles5. Psychosocial factors6. Unsatisfactory existing prostheses7. Lack of intra-arch and interarch integrity and stability8. Questionable prognosisa. Loss of tooth structure/integrityb. Periodontally compromisedc. Endodontically compromised9. Significance of tooth position2010 CDEL Re-recognition of the Specialty Report 141 of 279