Understanding Dental Code D5720

When to Use D5720 dental code

The D5720 dental code is designated for the rebase of a maxillary partial denture. Rebasing involves replacing the entire acrylic base material of an existing partial denture without changing the denture teeth. This procedure is typically performed when the base material has deteriorated, but the teeth remain in good condition. Use D5720 when the fit of the partial denture has become compromised due to changes in the patient’s oral anatomy or wear of the base, but a full replacement is not clinically necessary.

Documentation and Clinical Scenarios

Accurate documentation is essential for successful claim submission and reimbursement. For D5720, ensure the patient’s chart includes:

• Detailed clinical notes describing the condition of the existing partial denture and the reason for rebasing (e.g., ill-fitting base, tissue irritation, or base material degradation).
• Intraoral photographs or radiographs, if applicable, to support the clinical need.
• Documentation of alternative treatments considered and why rebasing was selected over a new prosthesis.
• Signed consent forms and a narrative explaining the necessity of the procedure.

Common clinical scenarios include patients with significant tissue changes post-extraction, after healing from surgery, or following long-term wear of the partial denture base.

Insurance Billing Tips

To maximize reimbursement and minimize denials for D5720:

• Verify patient benefits before treatment to confirm coverage for rebasing procedures. Many plans have frequency limitations or may require a specific time interval since the initial delivery of the partial denture.
• Submit comprehensive documentation with the claim, including clinical notes, narratives, and supporting images.
• Use the correct CDT code—D5720 for maxillary partial denture rebasing. For mandibular partials, see D5730.
• Review EOBs (Explanation of Benefits) carefully for denial reasons and be prepared to submit a claim appeal with additional documentation if necessary.
• Track AR (Accounts Receivable) to ensure timely follow-up on outstanding claims and reduce payment delays.

Example Case for D5720

Consider a patient who received a maxillary partial denture three years ago. Over time, the patient experiences discomfort and looseness due to tissue resorption. The denture teeth remain intact and functional, but the acrylic base no longer fits properly. After evaluating the patient, the dentist determines that a rebase is clinically appropriate. The dental team documents the patient’s history, takes intraoral photos, and submits a claim using D5720 along with a detailed narrative. Insurance approves the claim, and the patient receives a well-fitting, comfortable partial denture without the expense of a full replacement.

By following best practices in documentation and billing, dental offices can ensure accurate reimbursement and improved patient satisfaction when using the D5720 dental code.