D5947Resection Prosthesis, Mandibular, with Precision Attachments

What This Code Covers

D5947 covers resection prosthesis, mandibular, with precision attachments. A precision or semi-precision attachment connects the removable prosthesis to fixed abutments for improved retention. This code covers the attachment mechanism and is reported in addition to the prosthesis code.

Billing Guide

Bill this code when:

• The prosthetic device described by D5947 is fabricated and delivered
• The clinical indication and device design are documented
• The specific prosthesis type matches the code description

Do not bill this code when:

• A different prosthesis type was delivered
• The procedure is a modification or adjustment rather than a new fabrication
• The prosthesis type does not match this code description
• The procedure is better described by D5927 (Auricular prosthesis, replacement)

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.