We have a patient who will need a CuSil® partial. We are keeping seven teeth, and the partial will have rubber gaskets that sit over the retained teeth. The lab costs on this are more than a regular partial. What code should we bill?

Answer

The ADA discusses how to code a CuSil® partial denture on page 163 of CDT 2011/2012. It notes that D5211/D5212 are available (partial denture - resin base, including any conventional clasps, rests, and teeth) but also suggests billing D5899, by report if D5211/D5212 does not adequately describe the procedure. Since you indicated that the lab costs are considerably higher than a regular partial and the CuSil®partial involves an unconventional clasping system, billing D5899 may be the better option. Send a copy of the lab bill along with a narrative describing the type of partial.