D5958 — Palatal lift prosthesis, interim
An obturator closes a hole between the mouth and the nasal cavity or sinus. D5958 is the version for the upper jaw.
There are eleven codes for obturator and resection prosthesis and they are not interchangeable. This page covers this one; the obturator and resection prosthesis guide covers the treatment they all share.
The rest of this page deals with the specifics: the requirements written into the code, the usual range of fees, the typical benefit outcome, and how to tell it apart from its closest relatives.
Reading D5958
Arch — upper. The palate provides broad support for anything removable, but the sinuses sit directly above the back teeth, which constrains surgical work.
Status — interim, not definitive. It is built to function for a limited period while something else is planned or healing, and many plans fold its fee into the definitive restoration if that follows within a few months.
How D5958 differs from its neighbours
D5959 — Palatal lift prosthesis, modification: It is the definitive version.
D5955 — Palatal lift prosthesis, definitive: It is the definitive version.
D5954 — Palatal augmentation prosthesis: It is the definitive version.
D5937 — Trismus appliance (not for TMD treatment): It is the definitive version.
D5958 sits in a group of eleven codes in total; the remainder are linked at the foot of this page. A plan reads these codes as definitions, not as descriptions. If the notes for the visit do not match D5958 exactly, the claim is assessed as whichever of these the notes do match.
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 D5958
D5958 — what is it?
It is the maxillofacial prosthetics code for palatal lift prosthesis, interim, and it means that specific procedure and no other.
How much does D5958 cost?
Most private fees fall in $1,500–$6,000. Geography accounts for more of that spread than anything clinical.
Will my plan pay for D5958?
Usually yes, as medical / maxillofacial treatment at variable — but coverage turns on your own policy, its annual maximum and any waiting period.
What is the difference between D5958 and D5959?
D5959 is palatal lift prosthesis, modification: it is the definitive version. Nothing else separates them, which is exactly why a claim submitted under the wrong one of the two is such a common correction.
Also known as: obturator, palatal defect, oral cancer prosthesis, maxillary resection, speech aid.