D5671Replace All Teeth and Acrylic on Cast Metal Framework (Mandibular)

What This Code Covers

D5671 covers replace all teeth and acrylic on cast metal framework (mandibular). Components of an existing prosthesis are replaced or added to restore function. This is a modification to the current prosthesis, not a new fabrication.

Billing Guide

Bill this code when:

• The procedure described by D5671 is performed and documented
• The clinical indication supports the procedure
• Documentation meets the payer's requirements for the service

Do not bill this code when:

• A different procedure was actually performed
• The procedure is included in another code being billed at the same visit
• Documentation does not support the medical necessity of the procedure
• The procedure is better described by D5660 (Add clasp to existing partial denture - per tooth)

Insurance and Denial Prevention

Key Payer Rules:

• Most plans have frequency limits for denture replacement (typically once every 5-10 years)
• Relines, rebases, and repairs have separate frequency limits
• Prior authorization is commonly required for new complete and partial dentures
• Maxillofacial prosthetic codes may not be covered under standard dental plans

Common Denials and How to Respond:

• Frequency limit for replacement - Document why the current prosthesis cannot be repaired or relined and must be replaced.
• Prior authorization not obtained - Submit post-service with full documentation if prior auth was not obtained before delivery.
• Not a covered benefit - For maxillofacial prosthetics, check if coverage exists under the patient's medical plan rather than dental.