D5924 — Cranial prosthesis
D5924 is the cranial prosthesis that restores the contour of the skull where part of it has been removed.
This is one of 13 closely related facial and ocular prosthesis codes. The treatment is explained in full in the facial and ocular prosthesis guide — this page is about what makes this particular code different.
This page explains what that code number commits the office to, what it usually costs, how plans treat it, and — the part that causes most of the confusion — how it differs from the codes sitting immediately either side of it.
The nearby codes and how they differ
D5923 — Ocular prosthesis, interim: It is the interim version.
D5925 — Facial augmentation implant prosthesis: It is an implant placed to build up facial contour rather than to replace a missing part.
D5922 — Nasal septal prosthesis: It is the prosthesis that closes a hole in the nasal septum.
D5926 — Nasal prosthesis, replacement: It is the replacement nasal prosthesis, made once the original has aged or the tissue around it has changed.
D5924 sits in a group of 13 codes in total; the remainder are linked at the foot of this page. A single word separates several of these codes, and a payer reads that word literally. If the record does not support D5924 specifically, the claim comes back — usually repriced to whichever neighbouring code the reviewer thinks was actually performed.
Every code in this group
These codes describe the same broad procedure and differ in one respect each. Each has its own page with its own fee range and coverage notes.
Questions about D5924
What procedure is D5924?
Cranial prosthesis, reported under a single maxillofacial prosthetics code.
Is D5924 expensive?
Expect $3,000–$15,000. Ask for the number in writing, because the code carries no fee of its own and every practice sets its own.
Is D5924 a covered benefit?
Plans generally pay it as medical / maxillofacial treatment, variable, subject to whatever is left of your maximum for the year.
What is the difference between D5924 and D5923?
D5923 is ocular prosthesis, interim: it is the interim version. Apart from that, the two describe the same treatment — which is why the notes for the visit matter more here than the code itself.
Also known as: facial prosthesis, ocular prosthesis, nasal prosthesis, anaplastology, maxillofacial rehabilitation.