Understanding Dental Code D5660

When to Use D5660 dental code

The D5660 dental code is used when a clasp is added to an existing partial denture. This CDT code applies specifically to situations where a patient’s oral condition has changed—such as a new abutment tooth or increased mobility—and the partial denture requires an additional clasp for improved retention and stability. It is not used for the initial fabrication of a partial denture, but rather as a modification to an existing appliance. Proper use of D5660 ensures accurate billing and supports the clinical necessity of the procedure.

Documentation and Clinical Scenarios

Thorough documentation is essential when billing for D5660. Clinical notes should clearly describe the reason for the clasp addition, such as changes in tooth support or partial denture fit. Include intraoral photos, radiographs (if relevant), and a detailed narrative explaining the patient’s current dental status and why the clasp is needed. Common clinical scenarios include:

• A new abutment tooth has erupted or been restored, requiring additional retention.
• Existing clasps have become ineffective due to tooth movement or wear.
• The patient reports looseness or instability of the partial denture.

Always retain copies of lab slips and correspondence with the dental laboratory, as these support the claim and may be requested during an insurance audit or claim appeal.

Insurance Billing Tips

Successful billing for D5660 requires following best practices in insurance verification and claim submission. Here are actionable steps:

• Verify Coverage: Before treatment, confirm with the patient’s insurance carrier that modifications to partial dentures are covered and check for frequency limitations or waiting periods.
• Submit Detailed Claims: Attach clinical narratives, photos, and lab invoices to the claim. Use clear, concise language to justify the necessity of the added clasp.
• Use Correct Coding: Do not confuse D5660 with codes for new partial dentures (upper partial denture, lower partial denture) or repairs (repair broken partial denture base).
• Track EOBs and AR: Monitor Explanation of Benefits (EOBs) and Accounts Receivable (AR) to ensure timely payment. If denied, review the payer’s rationale and prepare a well-documented appeal if clinically justified.

Educating your front office and billing team on these steps can significantly reduce claim denials and improve cash flow.

Example Case for D5660

Case: A patient returns six months after receiving a lower partial denture. Due to shifting teeth, the appliance has become unstable. The dentist determines that adding a clasp to a newly restored molar will restore function and comfort. The clinical team documents the patient’s complaint, takes intraoral photos, and writes a narrative explaining the need for the clasp. After verifying insurance coverage, they submit a claim with all supporting documentation. The claim is approved, and the patient’s partial denture is successfully modified.

This example highlights the importance of thorough documentation, insurance verification, and clear communication with both the patient and the payer when using the D5660 dental code.