When is D5140 used?
The D5140 dental code applies to billing for immediate dentures—complete upper (maxillary) or lower (mandibular) dentures placed right after tooth extraction. This CDT code is appropriate when patients need full arch tooth removal and receive their denture the same day, preventing any period without teeth during recovery. D5140 must be differentiated from conventional denture codes (complete dentures) or partial denture codes, since immediate dentures require distinct clinical procedures and laboratory work.
D5140 Charting and Clinical Use
Accurate record-keeping is vital for proper D5140 reimbursement. Clinical documentation must clearly show:
Medical justification for immediate denture placement (such as teeth beyond repair, severe gum disease).
Count of extracted teeth and which arch is treated (upper or lower).
Before and after X-rays and study models.
Patient agreement and comprehension of the immediate denture procedure, including scheduled follow-up visits for modifications and relining.
Typical clinical situations involve patients with failing teeth from decay or injury, or individuals wanting quick denture placement for practical or cosmetic purposes. Documentation should always support the immediate timing of treatment and explain why standard dentures are not suitable initially.
Billing and Insurance Considerations
To improve payment success and reduce claim rejections for D5140, implement these strategies:
Coverage verification: Check patient benefits and denture frequency limits before starting treatment. Most insurance plans have waiting periods or restrictions (such as one denture per arch every 5–7 years).
Prior approval: Send pre-treatment requests with supporting materials, including clinical records, X-rays, and study models, to prevent claim denials.
Proper claim filing: Document the extraction date and immediate denture placement clearly. Use the appropriate CDT code (D5140) and identify which arch was treated.
EOB review: Check Explanation of Benefits statements quickly for denials or information requests. For denied claims, file appeals with comprehensive clinical reasoning and supporting documentation.
Benefit coordination: When patients have multiple insurance plans, coordinate coverage to optimize payment and reduce patient costs.
How dental practices use D5140
A 62-year-old patient comes in with severe gum disease and teeth that cannot be saved in the upper jaw. The treatment involves removing all upper teeth and placing an immediate complete upper denture. The dental team records the diagnosis, makes pre-treatment impressions, and arranges extraction and denture placement on the same visit. The insurance specialist confirms coverage, obtains prior approval with X-rays and clinical records, and submits D5140 on the service date. The claim gets approved, and the patient receives their immediate denture maintaining both function and appearance throughout treatment.
Following these procedures and maintaining complete documentation helps dental practices efficiently process D5140 billing while ensuring patients experience smooth denture treatment.
Common Questions
Can code D5140 be applied for replacing or relining an existing immediate denture?
No, D5140 is designated exclusively for the initial creation and placement of an immediate maxillary denture. Any replacement, relining, or repair work on an existing immediate denture requires different CDT codes. For relining procedures, appropriate codes include D5720 (chairside reline of complete maxillary denture) or D5750 (laboratory reline of complete maxillary denture). It's essential to confirm the proper code matches the specific treatment being performed.
Does a different code exist for immediate dentures in the lower jaw?
Yes, a distinct code applies to immediate dentures for the lower jaw. The correct CDT code for an immediate mandibular (lower jaw) denture is D5130. Code D5140 is exclusively designated for immediate maxillary (upper jaw) dentures. It's crucial to select the appropriate code corresponding to the specific arch receiving treatment.
What is the typical lifespan of an immediate denture before requiring a permanent replacement?
Immediate dentures serve as a temporary measure during the post-extraction healing phase. Their typical duration ranges from several months, usually 6 to 12 months, allowing sufficient time for gum tissue and bone to heal and stabilize. Following this healing period, new impressions are obtained and a permanent denture is created to provide superior fit and functionality.