Negotiated reimbursement rates for D5931 across 1 states, sourced from CMS Transparency in Coverage data. 3 rate records.
D5931 is designated for a modified surgical obturator, which is typically used when adjustments are made to an existing obturator to enhance fit or function. This may be necessary due to changes in the patient's anatomy post-surgery. Documentation should reflect the modifications made, the patient's current condition, and the rationale for the adjustment. Reimbursement for D5931 is generally lower than for a full obturator, and payor policies can vary, with some insurers providing limited coverage based on the specifics of the modification and the patient's needs.
Reimbursement rates for D5931 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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