When is D5987 used?
The D5987 dental code applies to commissure splints, which are custom dental devices designed to support and maintain the corners of the mouth in patients with impaired oral function. This procedure code is typically utilized for cases involving injury, post-surgical complications, or medical conditions like facial nerve damage that impact the oral commissures. Dental professionals should apply D5987 when creating and placing a commissure splint to address these particular clinical situations, helping patients restore both function and appearance of their oral structures.
D5987 Charting and Clinical Use
Proper record-keeping is crucial for effective billing of D5987. Dental offices must maintain comprehensive clinical records that detail the patient's condition, functional limitations, and why the commissure splint is medically necessary. Supporting materials such as clinical photographs, relevant imaging studies, and written explanations of why other treatment options are inadequate will help support the insurance claim. Common clinical situations include:
Individuals with facial nerve damage causing sagging at the mouth corners
Post-operative reconstruction patients requiring oral structural support
Accident victims with tissue damage at the commissure areas
Make certain that all records clearly demonstrate the relationship between the patient's medical condition and the requirement for the commissure splint, confirming that the device is individually crafted for each patient.
Billing and Insurance Considerations
When submitting claims for D5987, implement these strategies to improve approval rates and reduce processing issues:
Check benefits: Prior to beginning treatment, contact the patient's dental and medical insurance providers to determine if commissure splints are included in their coverage. Some insurers may need prior approval.
Provide complete documentation: Include detailed clinical records, photographs, and explanatory notes with your claim submission. Emphasize the medical requirement and individualized design of the device.
Apply proper coding: Make sure D5987 is designated as the main procedure code. When other prosthetic or surgical procedures are involved, document them appropriately and reference related codes such as miscellaneous maxillofacial prosthesis (D5999) where relevant.
Monitor claims processing: Review insurance responses for rejections or requests for more information. Address pending accounts receivable promptly and prepare to file appeals with additional supporting materials when necessary.
How dental practices use D5987
Take the example of a patient following surgical excision of a growth that affected the right oral commissure. The treatment team records the surgical site condition, captures before and after photographs, and creates a personalized commissure splint to help restore oral function and appearance. The practice confirms insurance benefits, files the claim with complete documentation and images, and obtains payment following one request for supplementary information from the insurance company. This practical example demonstrates how thorough documentation, advance insurance verification, and careful claim follow-up are essential for successful D5987 billing.
Understanding both the clinical applications and billing procedures for D5987 helps dental practices secure proper compensation while providing excellent patient treatment.
Common Questions
What materials are typically used in the fabrication of commissure splints billed under code D5987?
Commissure splints are commonly constructed using medical-grade acrylic resins or specialized thermoplastic materials. These materials are selected for their excellent durability, biocompatibility with oral tissues, and capacity for custom molding to accommodate each patient's specific oral structure. While material selection may differ based on individual patient requirements and practitioner preferences, all materials must comply with established safety and hygiene regulations.
What is the typical timeframe for fabricating and delivering a commissure splint under code D5987?
The complete process from fabrication to delivery of a commissure splint typically requires one to two weeks following the initial impression appointment. This timeframe encompasses taking precise impressions, laboratory construction of the appliance, proper fitting procedures, and completing any required adjustments to ensure maximum patient comfort and optimal functionality.
What aftercare guidelines should patients follow after receiving a commissure splint?
Patients must receive comprehensive instructions regarding proper cleaning protocols and maintenance procedures for their commissure splint to minimize infection risk and maximize appliance durability. Scheduled follow-up appointments are essential for monitoring proper fit and functionality, and patients should immediately contact their dental provider if they experience any discomfort or notice changes in their oral condition.