D5422Adjust Partial Denture - Mandibular

What This Code Covers

D5422 covers the chairside adjustment of a removable mandibular (lower) partial denture. The procedure includes sore spot relief, clasp adjustment, occlusal corrections, and border modifications to improve fit and comfort. This is the lower-arch counterpart to D5421.

Billing Guide

Bill this code when:

• An existing lower partial denture requires chairside adjustment
• Clasp adjustment, sore spot relief, or bite corrections are performed
• The adjustment is beyond the initial post-delivery follow-up period
• The denture is a removable partial (not a complete denture)

Do not bill this code when:

• A complete lower denture is adjusted. Use D5411
• An upper partial denture is adjusted. Use D5421
• A reline is performed. Use D5750 or D5751
• The adjustment is within the post-delivery inclusion period

Insurance and Denial Prevention

Key Payer Rules:

• Same rules as D5421 apply for mandibular partial denture adjustments
• Post-delivery adjustments are included in the partial denture fee for 30-90 days
• Clasp adjustments are included in D5422
• Frequency limits may apply

Common Denials and How to Respond:

• Within post-delivery period - Check the plan's inclusion period and bill after it ends.
• Frequency limit exceeded - Document the specific clinical need and consider whether the partial needs more extensive service.
• Wrong code - Verify whether the denture is a partial (D5422) or complete (D5411).