2025 CPT code 21082
Effective Date: N/A Surgery - Surgical Procedures on the Musculoskeletal System Feed
Impression and custom preparation of a palatal augmentation prosthesis.
Medical necessity is established by demonstrating that the palatal augmentation prosthesis is required to address a functional deficit, such as improving speech, swallowing, or protecting a surgical site. The documentation should clearly link the prosthesis to the patient's underlying condition and explain why it is essential for their health and well-being.
The physician prepares the patient, applies an irreversible hydrocolloid material to create an impression of the palate, and then makes a mold from this impression. Using the mold, they create the palatal augmentation prosthesis from a synthetic material, often acrylic resin.
In simple words: The doctor makes a custom device for the roof of your mouth. This device helps reshape the palate and can make it easier to speak and swallow, especially if you have trouble moving your tongue.
The physician takes an impression of the palate and uses it to custom-prepare a palatal augmentation prosthesis. This prosthesis helps reshape the hard palate (roof of the mouth) and can improve speech and swallowing in patients with impaired tongue mobility.
Example 1: A patient with a cleft palate requires a palatal augmentation prosthesis to assist with speech therapy., Following oral surgery, a patient needs a palatal augmentation prosthesis to protect the surgical site and aid in healing., A patient with dysarthria (difficulty speaking) due to cerebral palsy receives a palatal augmentation prosthesis to improve tongue-palate contact during speech.
Documentation should include the medical necessity for the prosthesis, such as the diagnosis (e.g., cleft palate, dysarthria, post-surgical need), the patient's functional limitations, and the anticipated benefits of the prosthesis. The impression and fabrication process should also be documented.
- Specialties:Prosthodontics, Oral and Maxillofacial Surgery, Otolaryngology, Plastic Surgery, Speech-Language Pathology
- Place of Service:Office, Hospital Outpatient Department, Ambulatory Surgical Center