D5226 Dental Code

D5226 Dental Code is the dental procedure for Mandibular partial denture – flexible base (including any clasps, rests and teeth).

The D5226 dental code refers to the dental procedure for a mandibular partial denture – flexible base, which includes all necessary components such as clasps, rests, and artificial teeth. This procedure code is part of the Current Dental Terminology (CDT) code set maintained by the American Dental Association (ADA), and it is widely used by dental professionals and insurance providers for accurate dental billing and claims processing.

The D5226 code specifically applies to a lower (mandibular) removable partial denture that features a flexible base material. This type of prosthesis is commonly recommended for patients who require a comfortable, adaptable, and esthetically pleasing replacement for missing lower teeth. The flexible base offers enhanced patient comfort and is often chosen when traditional rigid bases may not be ideal due to anatomical or functional concerns.

If you are preparing to submit insurance claims or billing documentation using the D5226 CDT code, it is important to first confirm that this procedure code is the most accurate match for the dental services provided. The CDT code set includes a variety of other partial denture codes, so evaluating similar or related codes—such as those for rigid base mandibular dentures or maxillary partial dentures—can help ensure precision in coding and avoid potential claim denials.

Selecting the correct CDT code is essential for streamlining reimbursement, minimizing insurance issues, and maintaining compliance with dental billing standards. Always consult the latest version of the CDT manual or a trusted dental coding resource before submitting your dental claims.

CDT Code D5226 should be used when billing for:

• A mandibular partial denture (lower jaw),
• Constructed with a flexible base material,
• And includes all integral components: clasps, rests, and artificial teeth.

If you are uncertain whether D5226 is the appropriate code for a particular dental procedure, or if you need help distinguishing between similar CDT codes, we recommend reviewing all applicable procedures or consulting with a dental billing specialist. Doing so ensures accurate documentation and helps facilitate timely insurance reimbursement.

D5226 Dental Code Definition

What is D5226 Dental Code?

The D5226 dental code is a CDT (Current Dental Terminology) procedure code that refers to the fabrication and delivery of a mandibular partial denture with a flexible base. This procedure includes the creation and placement of all necessary components, such as clasps, rests, and artificial teeth, to restore function and aesthetics in the lower dental arch.

CDT Code D5226 is used when a patient requires a removable lower partial denture made from a flexible base material, rather than a traditional rigid acrylic or metal framework. Flexible base dentures are valued for their comfort, adaptability, and lightweight design, making them especially suitable for patients with sensitive oral tissues or those seeking improved esthetics.

The D5226 dental procedure involves:

• Designing and fabricating a custom mandibular partial denture tailored to the patient’s oral anatomy.
• Incorporating flexible thermoplastic materials that allow the base to conform gently to the contours of the mouth.
• Including retentive elements such as clasps and rests for stability and retention.
• Placing replacement teeth that restore chewing function and help improve speech and appearance.

Dental professionals use CDT Code D5226 to accurately document and bill for this service when submitting dental insurance claims or managing internal patient records. Proper use of this code ensures clarity, billing accuracy, and consistency across dental offices, insurance companies, and patient care documentation.

It is important to confirm that the D5226 code is the most appropriate selection for the procedure performed, as there are other CDT codes available for partial dentures with rigid bases, maxillary arches, or alternative configurations. Choosing the correct CDT code not only helps avoid claim rejections but also supports transparent communication between dental providers and insurance payers.

The D5226 Dental Code should be used when a patient receives a lower partial denture made from flexible base materials, complete with clasps, rests, and artificial teeth, to replace missing teeth in the mandibular arch. This code represents a key part of modern removable prosthodontic treatment planning and billing.

D5226 Dental Code & CDT Codes Explained

What are CDT Codes (Current Dental Terminology)?

The D5226 dental code is part of the CDT (Current Dental Terminology) code set, which is a standardized system developed and maintained by the American Dental Association (ADA). CDT codes are used by dental professionals, insurance carriers, and billing departments across the United States to accurately document and report dental services, procedures, and treatments.

CDT codes serve as the official procedural language of dentistry, and they are essential for ensuring consistency in dental claims submission, insurance reimbursement, treatment documentation, and compliance with federal regulations, including HIPAA.

The D5226 CDT code specifically refers to the procedure for fabricating and delivering a mandibular partial denture with a flexible base, including necessary components such as clasps, rests, and artificial teeth. Like all CDT codes, D5226 provides an exact and universally accepted way to describe a dental service, reducing confusion and discrepancies between dental practices and third-party payers.

CDT codes are revised and updated annually by the ADA to reflect changes in clinical practices, innovations in dental technology, and evolving insurance requirements. This ensures that dental professionals have access to the most current and relevant codes when documenting patient care and processing claims. Each year, codes may be added, deleted, or revised, which is why it is important to use the most up-to-date version of the CDT code set.

Key uses of CDT codes like D5226 include:

• Accurate dental billing for procedures such as partial dentures, crowns, root canals, cleanings, and more.
• Efficient insurance claims processing with dental benefit plans and third-party payers.
• Clear communication between dental providers, patients, and insurance companies.
• Legal and regulatory compliance, as CDT codes are required under HIPAA for electronic health records and claims submissions.

By understanding CDT codes and their function, dental professionals can ensure that procedures like D5226 – mandibular partial denture, flexible base are reported correctly, minimizing delays and denials in claim processing.

Whether you’re a dental provider, office manager, billing coordinator, or patient looking to understand your treatment plan better, having access to reliable CDT code information—such as that provided here for D5226—can help clarify procedures and improve the overall efficiency of dental care delivery.

For comprehensive and regularly updated information about D5226 and other CDT dental codes, be sure to explore our full CDT code directory or consult with a certified dental billing expert.

What professionals use D5226 Dental Code and Other CDT Codes?

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What Professionals Use D5226 Dental Code and Other CDT Codes?

The D5226 dental code, along with all other CDT (Current Dental Terminology) codes, is used by a wide range of dental and healthcare professionals involved in patient treatment, dental billing, coding, insurance claims, and practice management. These procedure codes—maintained and published annually by the American Dental Association (ADA)—form the standardized language for documenting dental services across the United States.

The D5226 code, which specifically refers to a mandibular partial denture with a flexible base, is a common billing and treatment code used in both general and specialized dentistry. Dental professionals rely on this code to ensure that partial denture procedures are recorded correctly and that insurance claims are processed smoothly and accurately.

The professionals and entities who frequently use D5226 and other CDT codes include:

• General Dentists and Prosthodontists: These dental providers use the D5226 CDT code when diagnosing and treating patients who require a flexible lower partial denture. It allows them to communicate the exact treatment provided, both in the patient record and in billing documentation.
• Dental Office Managers and Billing Coordinators: Administrative staff responsible for insurance claims and billing rely on CDT codes like D5226 to submit accurate claims to dental insurance companies. Using the correct code helps ensure timely reimbursement and reduces the risk of claim denials or delays.
• Dental Insurance Companies and Third-Party Payers: Insurance carriers require the use of CDT codes, including D5226, when reviewing dental treatment plans and approving coverage. These codes provide a universally recognized format that simplifies claim processing and benefit determination.
• Dental Hygienists and Assistants (Supporting Documentation): While hygienists and assistants may not submit billing directly, they often play a role in documenting clinical procedures and assisting dentists with coding selection during or after treatment.
• Healthcare IT Systems and Electronic Health Records (EHR) Platforms: Dental practice management software and EHR systems are programmed to include CDT codes, enabling providers to chart procedures, track treatment history, and streamline billing processes electronically.
• Public Health Dentists and Medicaid/Medicare Administrators: Government programs like Medicaid and state-funded dental benefit plans also require the use of CDT codes for claim approval, compliance, and reporting. Codes like D5226 help ensure that services provided under public programs are correctly categorized and reimbursed.

All CDT codes—including D5226 for mandibular partial denture with flexible base—are part of the ADA’s Code on Dental Procedures and Nomenclature, which is updated every year to reflect evolving treatment methods, new technologies, and industry feedback. This makes the CDT code set an essential tool for anyone involved in dental care delivery or administration.

Do you need expert assistance with the D5226 Dental Code or any other CDT (Current Dental Terminology) codes? Our dedicated and knowledgeable team at CDT-Codes.com is here to help you navigate any questions or concerns you may have regarding dental procedure coding. Whether you are a dental professional, office manager, billing coordinator, or a patient trying to understand treatment details, we are happy to assist you with any CDT code-related matters, including code selection, billing support, claim clarification, and procedural definitions.

If you are unsure whether D5226 – Mandibular partial denture with flexible base is the most appropriate code for the service provided, or if you want help comparing it with similar codes, our expert support staff can guide you through the coding process to ensure accuracy and compliance. Simply reach out to us using the contact us form page or submit a question in the comments form below, and a member of our professional support team will respond as promptly as possible.

At CDT-Codes.com, we take pride in being a trusted and leading online resource for accurate, updated, and easy-to-understand CDT code information. Our platform is designed to help dental professionals and patients alike find reliable definitions and billing descriptions for codes such as D5226, along with hundreds of other dental procedure codes used daily in dental practices across the country. We aim to be the most comprehensive and helpful source for CDT codes available online.

We are committed to keeping all content on our website as current and informative as possible. When updates or revisions to the D5226 code or any other dental procedure codes are released—either by the American Dental Association (ADA) or reported by our users—we thoroughly review and verify the new information before publishing it on our site. If you discover additional or updated details for the D5226 Dental Code, we encourage you to notify us. Please send us your findings using the contact form or post a comment below. Once verified, we will promptly update the page to ensure accuracy and relevance for the entire dental community.

Please note that CDT-Codes.com is a high-quality, independent informational website. We are not affiliated with the ADA, nor are we connected to any government agencies, state dental boards, insurance companies, or professional medical organizations. Our mission is purely to provide reliable, up-to-date CDT code information that can support dental billing, coding education, and procedural transparency.

If you need more information or wish to explore other commonly used dental codes beyond D5226, browse our site for detailed CDT code descriptions, explanations, and updates. We’re here to help ensure your dental billing process is as smooth and accurate as possible.

Additional CDT Codes (Code on Dental Procedures and Nomenclature)
D5281 Dental Code
D5282 Dental Code
D5283 Dental Code
D5284 Dental Code
D5286 Dental Code
D5410 Dental Code
D5411 Dental Code
D5421 Dental Code
D5422 Dental Code
D5510 Dental Code