© Copyright 2025 American Medical Association. All rights reserved.
A surgical obturator prosthesis is a specialized device utilized to effectively close a defect in the hard palate and maxilla, which may arise from congenital conditions, such as cleft palate, or as a result of surgical interventions like tumor resections. This prosthesis plays a critical role in restoring the functional and aesthetic aspects of the oral cavity. It is custom-prepared prior to the surgical procedure and is designed to be placed during the surgery itself. The primary function of the obturator is to temporarily restore the continuity of the hard palate immediately following surgical intervention. By doing so, it separates the oral cavity from the nasal cavity, which is essential for various functions including chewing, swallowing, and speech. Additionally, the obturator aids in providing occlusion with the mandible, supports the mandible, and contributes to a cosmetically acceptable appearance for the patient. Prior to the surgical placement of the obturator, the prosthetist takes an impression of the defect along with other relevant structures in the mouth. This may be supplemented by radiological studies, such as a CT scan, to thoroughly evaluate the anatomical features. Following this assessment, a mold is created, and the custom prosthesis is constructed to meet the specific needs of the patient, ensuring optimal fit and function during the recovery period.
© Copyright 2025 Coding Ahead. All rights reserved.
The surgical obturator prosthesis is indicated for use in patients who have defects in the hard palate and maxilla due to various conditions. These include:
The procedure for preparing and placing a surgical obturator prosthesis involves several critical steps to ensure proper fit and function. These steps include:
After the surgical placement of the obturator prosthesis, patients can expect a period of adjustment as they become accustomed to the device. Post-procedure care may include monitoring for any discomfort or complications, as well as follow-up appointments to assess the fit and function of the obturator. Patients may also receive guidance on oral hygiene practices to maintain the health of the surrounding tissues. The obturator is intended to be a temporary solution, and further evaluations may be necessary to determine if additional interventions or a more permanent prosthesis is required as the patient heals.
| Short Descr | IMPRES&PREP SURG OBT PROSTH | Medium Descr | IMPRESSION&PREPARATION SURGICAL OBTURATOR PROSTH | Long Descr | Impression and custom preparation; surgical obturator prosthesis | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 32 - Other non-OR therapeutic procedures on nose, mouth and pharynx |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 1996-01-01 | Added | First appearance in code book in 1996. |
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