Understanding Dental Code D5988

When to Use D5988 dental code

The D5988 dental code is designated for the fabrication of a surgical splint. This CDT code is most commonly used when a patient requires stabilization of the jaw or teeth during surgical procedures, such as orthognathic surgery, trauma management, or certain periodontal surgeries. It is important to use D5988 only when the splint is custom-made and serves a surgical purpose, rather than for routine occlusal guards or night guards, which have their own distinct codes. Proper code selection ensures compliance and accurate reimbursement.

Documentation and Clinical Scenarios

Accurate documentation is crucial when billing for D5988. The clinical notes should clearly describe the medical necessity for the surgical splint, including the diagnosis, surgical plan, and how the splint will be used intraoperatively or postoperatively. Common scenarios include:

 
• Stabilizing fractured jaws following trauma
 
• Supporting bone segments during orthognathic surgery
 
• Maintaining tooth position during complex periodontal or implant procedures

Include preoperative radiographs, intraoral photographs, and a detailed narrative explaining why a surgical splint is required. This documentation will support the claim and reduce the risk of denials or requests for additional information.

Insurance Billing Tips

When billing D5988, follow these best practices to maximize claim acceptance:

 
• Verify patient benefits: Confirm with the payer that surgical splints are a covered benefit under the patient’s dental or medical plan. Some plans may require preauthorization.
 
• Submit supporting documentation: Always attach clinical notes, diagnostic images, and a detailed narrative to your claim. This helps justify medical necessity.
 
• Use correct coding: Do not substitute D5988 for non-surgical appliances. If the splint is for non-surgical use, consider codes such as occlusal guard or night guard.
 
• Appeal denials promptly: If the claim is denied, review the Explanation of Benefits (EOB), address the payer’s concerns, and submit a detailed appeal with additional documentation if needed.

Staying proactive with insurance verification and thorough documentation can significantly improve your accounts receivable (AR) and reduce delays in reimbursement.

Example Case for D5988

Case: A 28-year-old patient presents with a mandibular fracture following a bicycle accident. The oral surgeon determines that a custom surgical splint is necessary to stabilize the jaw during healing. The dental team documents the diagnosis, surgical plan, and the fabrication of the splint. Preoperative radiographs and intraoral photos are included in the patient’s record. The claim is submitted with D5988, along with all supporting documentation. Insurance reviews the claim, finds the documentation sufficient, and approves payment for the procedure.

This example highlights the importance of precise documentation, proper code selection, and proactive communication with payers to ensure successful reimbursement for surgical splints under D5988.