D1517Space Maintainer - Fixed, Bilateral, Mandibular

What This Code Covers

D1517 covers the fabrication and cementation of a fixed bilateral space maintainer on the lower (mandibular) arch. This appliance is cemented on both sides of the arch to hold space open for permanent teeth when multiple primary teeth have been lost prematurely. Common designs include a lingual holding arch that connects anchor teeth on both sides of the lower jaw.

Billing Guide

Bill this code when:

• A fixed bilateral space maintainer is cemented on the mandibular (lower) arch
• The appliance spans both sides of the arch to maintain space for unerupted permanent teeth
• Multiple primary teeth have been lost prematurely on both sides of the lower jaw

Do not bill this code when:

• The space maintainer is on the maxillary (upper) arch. Use D1516
• Only one side of the arch is involved. Use D1510 (fixed unilateral)
• A removable bilateral appliance is provided. Use D1527
• A resin-bonded bilateral space maintainer is placed. Use D1526

Insurance and Denial Prevention

Key Payer Rules:

• Most pediatric dental plans cover space maintainers as a preventive benefit
• Frequency limitations typically allow one space maintainer per arch per lifetime or per 5-year period
• Some payers require documentation that the primary tooth was lost prematurely
• Age limits may apply, typically under 14 years of age

Common Denials and How to Respond:

• Frequency limit exceeded - If replacing a previously placed appliance, document the clinical reason (lost, broken, outgrown) and submit radiographs.
• Should be D1510 - Clarify that both sides of the lower arch are involved. Describe the bilateral lingual arch design.
• Not medically necessary - Submit radiographs showing developing permanent teeth and document the risk of space loss without the appliance.