D5511Repair Broken Complete Denture Base, Mandibular

What This Code Covers

D5511 covers the repair of a broken or cracked mandibular (lower) complete denture base. The repair rejoins the broken pieces of the acrylic base to restore the denture to a functional condition. This may be done chairside or sent to a dental lab depending on the severity of the break. The code covers the repair of the base only, not replacement of missing teeth.

Billing Guide

Bill this code when:

• A complete lower denture base is cracked or broken and needs repair
• The broken pieces are rejoined with acrylic or other repair material
• The repair restores the denture to functional condition
• The denture base is the component that is broken (not a tooth)

Do not bill this code when:

• The denture is an upper (maxillary) complete denture. Use D5510
• A denture tooth needs replacement. Use D5520 (each tooth)
• A partial denture base is repaired. Use D5611 or D5621
• The denture needs a reline, not a repair. Use D5750 or D5751
• The denture is beyond repair and needs replacement

Insurance and Denial Prevention

Key Payer Rules:

• D5511 is typically a covered benefit with modest reimbursement
• Most plans cover denture repairs without frequency limits
• If the denture has been repaired multiple times, the payer may question whether replacement is more appropriate
• The repair code does not have the same frequency limit as denture replacement

Common Denials and How to Respond:

• Denture should be replaced - Document that the repair is sufficient to restore function and that the overall denture condition justifies repair over replacement.
• Wrong arch code - Verify the denture is mandibular (D5511) not maxillary (D5510).
• Repair plus reline on same date - A repair and a reline can sometimes be billed on the same date if both are needed. Document both procedures.