1. NPM Knowledge Base
  2. Medical billing in dentistry

Medical Billing for Obturators

Guidance for dental practice's billing a patient's medical insurance for obturators

The word Obturator is derived From the Latin word obturare, meaning “to close up”

For example, a palatal obturator is a prosthesis that totally occludes an opening such as an oronasal fistula.

Diagnosis coding will vary dependent on the patient’s conditions. Here are several example of commonly used diagnostic codes below:

ICD-10 codes:

M25.18 - Fistula, other specified site

J34.89 - Other specified disorders of nose and nasal sinuses

Q35.1 - Cleft hard palate

Q35.3 - Cleft soft palate

Q35.5 - Cleft hard palate with cleft soft palate

Q35.9 - Cleft palate, unspecified

Q38.5 - Congenital malformations of palate, not elsewhere classified

M27.8 - Other specified diseases of jaws

K08.89 - Other specified disorders of teeth and supporting structures

M27.0 - Developmental disorders of jaws

CPT codes:

21076 - Impression and custom preparation; surgical obturator prosthesis

21079 - Impression and custom preparation; interim obturator prosthesis

21080 - Impression and custom preparation; definitive obturator prosthesis

21081 - Impression and custom preparation; mandibular resection prosthesis

21082 - Impression and custom preparation; palatal augmentation prosthesis

21083 - Impression and custom preparation; palatal lift prosthesis

21084 - Impression and custom preparation; speech aid prosthesis

21085 - Impression and custom preparation; oral surgical prosthesis