PROSTHODONTICS - American College of Prosthodontists

32 Parameters of Care Tupac et alis the responsibility of the prosthodontist to be familiar with the different types of implants because eachsystem has its own intricacies and capabilities. The prosthodontist should be knowledgeable about anyimplant system recommended and/or used in patient treatment.Initially, prosthodontic restorations supported and/or retained by implants have had the greatestimpact on completely edentulous patients. In fact, the McGill Proclamation declares the two-implantmandibular overdenture as the first choice for the completely edentulous patient. Today implants canbe used in the partially edentulous patient for a variety of applications. Whether it is the conservation ofhealthy abutment teeth by using single or multiple implant replacements of teeth instead of conventionalfixed prosthodontics, or perhaps the reduction in prosthetically influenced alveolar resorption by implantsupported/retainedcomplete dentures, the impact of implant prosthodontics will continue to improvethe health and comfort of patients. Treatment of only the area of pathology without sacrificing orjeopardizing adjacent healthy tissues is now a reality.A refractory patient is one who presents with chronic complaints following appropriate therapy. Inthose instances where patient expectations exceed physical limitations, a mutually satisfactory resultmay not be possible through the completion of their treatment plan.General Criteria and StandardsInformed consent: All prosthodontic procedures should be preceded by the patient’s consent. Informedconsent is obtained after the patient has been informed of the indications for the procedure(s), goalsof treatment, the known benefits and risks of the procedure(s), the factor(s) that may affect the knownrisks and complications, the treatment options, the need for active maintenance by the patient, the needfor future replacements and revisions, and the favorable outcome.Documentation: Parameters of care for prosthodontic procedures include documentation of objectivefindings, diagnosis, and patient-management intervention.Coding and NomenclatureDiagnostic and procedural codes have been included in the ACP Parameters of Care only for generalguidance. The codes listed may not be all-inclusive or represent the most current or specific choices. Theinclusion of codes is not meant to supplant the use of current coding books or to relieve practitionersof their obligation to remain current in diagnostic and procedural coding. The ACP Committee onParameters of Care and Committee on Nomenclature do not endorse the use of this document as acoding manual.The diagnostic and procedural codes listed throughout this section may not be all-inclusive and shouldserve only as practice guidelines. ICD-9-CM (International Classification of Diseases, Ninth Revision, ClinicalModification) diagnostic codes may change yearly and must be reviewed and updated annually to ensureaccuracy. Specific diagnoses must be obtained from a current, recognized ICD-9-CM code source andsubstantiated 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 TerminologyC○ 2002, 2004 American Dental Association. All rights reserved.2010 CDEL Re-recognition of the Specialty Report 72 of 279