Understanding Dental Code D1552

When to Use D1552 dental code

The D1552 dental code is designated for the re-cementation or re-bonding of a bilateral space maintainer. This CDT code is used when an existing bilateral space maintainer—originally placed to preserve arch length after premature loss of primary teeth—becomes loose or detached and requires professional reattachment. It is important to note that D1552 applies only to bilateral appliances; for unilateral appliances, refer to the appropriate code. Proper use of D1552 ensures accurate billing and helps avoid claim denials due to miscoding.

Documentation and Clinical Scenarios

Accurate documentation is essential when billing for D1552. Dental teams should record the following in the patient’s chart:

 
• Date of original space maintainer placement
 
• Reason for re-cementation or re-bonding (e.g., accidental dislodgement, normal wear)
 
• Type and location of the appliance (confirm it is bilateral)
 
• Clinical notes on the procedure performed
 
• Pre- and post-procedure radiographs or intraoral photos, if available

Common clinical scenarios include a child returning for a loose bilateral space maintainer after sports activity or routine chewing. In these cases, the dentist assesses the appliance, cleans the abutment teeth, and re-cements or re-bonds the device, restoring its function.

Insurance Billing Tips

For successful reimbursement, follow these best practices:

 
• Verify coverage: Before treatment, check the patient’s dental benefits for space maintainer repairs. Many plans cover re-cementation, but frequency limitations may apply.
 
• Use precise coding: Always use D1552 for bilateral appliances. If the space maintainer is unilateral, use the code for re-cementing a unilateral space maintainer.
 
• Submit supporting documentation: Attach clinical notes, photos, and radiographs to the claim. This supports medical necessity and expedites claim processing.
 
• Review EOBs: Carefully check Explanation of Benefits statements for payment accuracy. If the claim is denied, review the denial reason and submit a timely appeal with additional documentation if needed.
 
• Track AR: Monitor accounts receivable to ensure prompt follow-up on unpaid claims related to D1552 procedures.

Example Case for D1552

Case: A 7-year-old patient returns to the office after their bilateral lower space maintainer becomes loose during recess. The dental assistant confirms the appliance is intact and bilateral. The dentist cleans the abutment teeth, checks the fit, and re-cements the appliance. Clinical notes detail the incident, and intraoral photos are taken. The billing team submits a claim using D1552, including the clinical narrative and photos. The insurer processes the claim and issues payment, as the documentation clearly supports the procedure’s necessity.

This example highlights the importance of accurate coding, thorough documentation, and proactive insurance communication to ensure proper reimbursement for D1552 procedures.