As a service to clinicians in the United States, Solvay® Dental 360 provides resources to assist with coding, coverage, and reimbursement for removable partial dentures (RPDs) fabricated using Ultaire® AKP. The Solvay® Dental 360 reimbursement support center recommends the following avenues for reimbursement success.
Solvay® Dental 360
Since Ultaire® AKP is distinctly different from metal or flexible RPD materials, properties, and processes, the existing dental codes for RPDs are not applicable.
We recommend all prescribers of Ultaire® AKP RPDs who are submitting claims to insurers, use the generic prosthesis code D5899 and include the materials from the Reimbursement Guide to fight for at least equivalent reimbursement as a metal RPD.
Here you can find resource materials to download for your reference. These coding suggestions do not replace coding advice from payers and/or institution coding and compliance staff. The ultimate responsibility for correct coding lies with the provider of service. However, these resources outline the reasoning for why current CDT codes are not applicable for Ultaire® AKP and should be shared with the payers when submitting claims. Solvay® Dental 360 makes no guarantee that the use of this information will prevent differences of opinion or disputes with third-party payers as to the correct form of billing or the amount that will be paid to providers of service.
American Dental Association (ADA) Concierge (for ADA members only)
Alternatively, as you prescribe more and more Ultaire® AKP partial dentures, we urge you to formally file a complaint with the ADA for having insufficient dental procedure code representation for RDPs made from Ultaire® AKP and to encourage them to support a new CDT procedure code for RDPs made from high-performance polymers.