Understanding Dental Code D5740

When to Use D5740 dental code

The D5740 dental code is used to report the direct reline of a maxillary partial denture. This CDT code applies when a patient’s existing upper partial denture requires a new lining material to improve fit and comfort, and the procedure is performed chairside in the dental office (not sent to a lab). Common indications include changes in oral anatomy due to bone resorption, tissue changes, or discomfort caused by an ill-fitting prosthesis. Use D5740 when the reline is completed in a single visit, with the dentist or clinical team directly applying and curing the reline material.

Documentation and Clinical Scenarios

Accurate documentation is essential for successful reimbursement and compliance. For D5740, best practices include:

• Clinical notes detailing the patient’s complaints (e.g., looseness, sore spots), findings (e.g., tissue changes, loss of retention), and the decision to reline.
• Pre- and post-operative photos (if possible) to demonstrate the need and outcome.
• Details of the procedure, including the type of reline material used, the steps performed, and patient tolerance post-procedure.
• Date of original partial denture placement, as some payers require this for benefit determination.

Typical clinical scenarios for D5740 include patients with recent extractions, significant weight loss, or those experiencing discomfort due to changes in their maxillary arch. Always confirm that the reline is performed directly in the office, as indirect/laboratory relines require a different code (D5750 for indirect reline of maxillary partial denture).

Insurance Billing Tips

To maximize reimbursement and minimize denials for D5740, follow these insurance billing best practices:

• Verify frequency limitations: Many dental plans limit relines to once every 12–24 months per prosthesis. Check the patient’s benefits before treatment.
• Submit supporting documentation: Attach clinical notes, photos, and the date of original denture delivery with your claim.
• Use correct CDT coding: Ensure the procedure was performed chairside and not sent to a lab. If the reline is indirect, use the appropriate code (D5750).
• Appeal denials with evidence: If a claim is denied, submit an appeal with detailed documentation showing medical necessity and frequency compliance.
• Track AR and EOBs: Monitor accounts receivable and explanation of benefits to ensure timely payment and address discrepancies promptly.

Example Case for D5740

Case Study: A 67-year-old patient presents with an upper partial denture placed three years ago. She reports looseness and sore spots. Examination reveals tissue changes and loss of retention. The dentist recommends a chairside reline. The clinical team documents the patient’s complaints, captures pre- and post-procedure photos, and notes the use of a soft reline material. The claim is submitted with all supporting documentation, and insurance reimburses the procedure without issue. This example highlights the importance of thorough documentation and correct code selection for successful billing.

By understanding when and how to use the D5740 dental code, dental teams can ensure accurate billing, improved patient outcomes, and optimal practice revenue.