Negotiated reimbursement rates for D5942 across 1 states, sourced from CMS Transparency in Coverage data. 3 rate records.
The CDT code D5942 refers to an adjustment made to a mandibular resection prosthesis. This procedure is necessary when the prosthesis does not fit properly due to changes in the patient's anatomy or other factors. Clinical indications include discomfort, difficulty in mastication, or speech issues. Documentation should detail the specific adjustments made, the patient's feedback, and any relevant clinical observations. Reimbursement for D5942 is typically low, averaging around $3, and can vary by payor and state, with some insurance plans offering limited coverage for adjustments to prosthetic devices.
Reimbursement rates for D5942 vary significantly by state, payor, and provider network. The national average negotiated rate is $3. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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