Coding: Browse HCPCS Level II 2020 Edition

Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

D5911 - D5999 Maxillofacial Prosthetics

D5911

Facial moulage (sectional)

short

Facial moulage sectional

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	YYY

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	1.0	3 Date of Service Edit: Clinical	Nature of Service/Procedure
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Service/Procedure

D5912

Facial moulage (complete)

short

Facial moulage complete

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	YYY

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	1.0	2 Date of Service Edit: Policy	Code Descriptor / CPT Instruction
OPH	1.0	2 Date of Service Edit: Policy	Code Descriptor / CPT Instruction

D5913

Nasal prosthesis

short

Nasal prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5914

Auricular prosthesis

short

Auricular prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5915

Orbital prosthesis

short

Orbital prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5916

Ocular prosthesis

short

Ocular prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5919

Facial prosthesis

short

Facial prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5922

Nasal septal prosthesis

short

Nasal septal prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5923

Ocular prosthesis, interim

short

Ocular prosthesis interim

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5924

Cranial prosthesis

short

Cranial prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5925

Facial augmentation implant prosthesis

short

Facial augmentation implant

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5926

Nasal prosthesis, replacement

short

Replacement nasal prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5927

Auricular prosthesis, replacement

short

Auricular replacement

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5928

Orbital prosthesis, replacement

short

Orbital replacement

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5929

Facial prosthesis, replacement

short

Facial replacement

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5931

Obturator prosthesis, surgical

short

Surgical obturator

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5932

Obturator prosthesis, definitive

short

Postsurgical obturator

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5933

Obturator prosthesis, modification

short

Refitting of obturator

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5934

Mandibular resection prosthesis with guide flange

short

Mandibular flange prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5935

Mandibular resection prosthesis without guide flange

short

Mandibular denture prosth

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5936

Obturator/prosthesis, interim

short

Temp obturator prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5937

trismus appliance (not for TMD treatment)

short

Trismus appliance

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5951

Feeding aid

short

Feeding aid

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	YYY

MUE

Location	Value	Ajudication Indicator	Rationale
OPH	0.0	3 Date of Service Edit: Clinical	CMS Policy

D5952

Speech aid prosthesis, pediatric

short

Pediatric speech aid

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5953

Speech aid prosthesis, adult

short

Adult speech aid

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5954

Palatal augmentation prosthesis

short

Superimposed prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5955

Palatal lift prosthesis, definitive

short

Palatal lift prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5958

Palatal lift prosthesis, interim

short

Intraoral con def inter plt

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5959

Palatal lift prosthesis, modification

short

Intraoral con def mod palat

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5960

Speech aid prosthesis, modification

short

Modify speech aid prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5982

Surgical stent

short

Surgical stent

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5983

Radiation carrier

short

Radiation applicator

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	YYY

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Equipment

D5984

Radiation shield

short

Radiation shield

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	YYY

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	1.0	3 Date of Service Edit: Clinical	Nature of Service/Procedure
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Service/Procedure

D5985

Radiation cone locator

short

Radiation cone locator

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	YYY

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	1.0	3 Date of Service Edit: Clinical	Nature of Service/Procedure
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Service/Procedure

D5986

Fluoride gel carrier

short

Fluoride applicator

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5987

Commissure splint

short

Commissure splint

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	YYY

D5988

Surgical splint

short

Surgical splint

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5991

Vesiculobullous disease medicament carrier

short

Vesiculobullous disease carr

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5992

Adjust maxillofacial prosthetic appliance, by report

short

Adjust max prost appliance

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5993

Maintenance and cleaning of a maxillofacial prosthesis (extra- or intra-oral) other than required adjustments, by report

short

Main/clean max prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5994

Peridontal medicament carrier with peripheral seal - laboratory processed

short

Peridontal medicament

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

D5999

Unspecified maxillofacial prosthesis, by report

short

Maxillofacial prosthesis

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX