D5916 Ocular prosthesis
Also known as: artificial eye, ocular prosth, eye replacement, prosthetic eye
Ocular prosthesis. A custom removable device that replaces a missing or damaged eye.
In Plain Language
artificial eye; replacement eye
Clinical Context
Indicated for enucleation, phthisical eyes, or severe ocular trauma. Provides cosmetic restoration and psychological benefit to patients.
RVU Information
CPT D5916 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
Dental codes (CDT codes) require documentation of the tooth number(s) or area treated, clinical findings, and the procedure performed. Pre-authorization may be required for major restorative, prosthodontic, and oral surgery procedures. Include radiographs when supporting medical necessity.
Specialties
Frequently Asked Questions
What is CPT code D5916?
CPT D5916 (Ocular prosthesis) is a D Codes (Dental) code. Ocular prosthesis. A custom removable device that replaces a missing or damaged eye.
Is D5916 covered by dental insurance?
CPT D5916 is a dental procedure code used by Prosthodontics, Ophthalmology, Maxillofacial Surgery. Indicated for enucleation, phthisical eyes, or severe ocular trauma. Provides cosmetic restoration and psychological benefit to patients. Coverage depends on your dental insurance plan.
When is CPT D5916 used?
Indicated for enucleation, phthisical eyes, or severe ocular trauma. Provides cosmetic restoration and psychological benefit to patients.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.