Negotiated reimbursement rates for D5913 across 1 states, sourced from CMS Transparency in Coverage data. 13 rate records.
D5913 pertains to the creation of a nasal prosthesis, which is a specialized device designed to restore the appearance and function of the nose. This procedure is clinically indicated for patients who have lost their nasal structure due to trauma, surgery, or congenital conditions. Documentation for this procedure should include a thorough clinical evaluation, photographs, and a clear statement of medical necessity. Reimbursement for D5913 is typically low, averaging around $1, reflecting the complexity and variability in coverage by different payors. Many insurance plans may not recognize this procedure as a covered benefit, leading to challenges in obtaining reimbursement. Therefore, dental billing professionals should be prepared to advocate for the procedure's necessity and navigate the complexities of insurance claims.
Reimbursement rates for D5913 vary significantly by state, payor, and provider network. The national average negotiated rate is $1. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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