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The Regence Group Dental Policy
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Prosthodontics Section - Tissue Conditioning

Topic: Tissue Conditioning Last Reviewed Date: 01/2003
Section: Prosthodontics Policy No: 38
Revised/Effective Date: 01/2003 Next Review Date: 01/2005


IMPORTANT INFORMATION
This Dental Policy has been developed through consideration of generally accepted standards of dental practice, review of dental literature, dental necessity, and as appropriate, government approval.

Benefit determinations should be based in all cases on the applicable contract language. To the extent there are any conflicts between these guidelines and the contract language, the contract language will control.

The purpose of dental policy is to provide a guide to coverage. Dental policy is not intended to dictate to providers how to practice dentistry. Providers are expected to exercise their clinical judgment in providing the most appropriate care.


Description

Tissue conditioning, maxillary (D5850):
Treatment reline using materials designed to heal unhealthy ridges prior to more definitive final restoration.

Tissue conditions, mandibular (D5851):
Treatment reline using materials designed to heal unhealthy ridges prior to more definitive final restoration.

Policy/Criteria
Procedure is in accordance with generally accepted standards of dental practice.

Administrative Guidelines
Process to contract benefits.

Codes Number Description
CDT
D5000-D6999  

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