D5820 is the CDT code for an interim upper partial denture, the flipper, with clasps, rests, and teeth included in one fee.
- When to use: The upper arch needs a short-term partial while an implant, bridge, or definitive partial is completed, even if it is seated on extraction day.
- When not to use: A lower flipper is D5821, an immediate partial meant as the definitive prosthesis is D5221, and an interim complete upper denture is D5810.
- Billing note: Many plans exclude interim prostheses or bundle them into the definitive treatment, so verify interim coverage by name before the lab work starts.
What D5820 covers
D5820 reports an interim partial denture for the upper arch, the prosthesis everyone outside a CDT manual calls a flipper. It is typically an acrylic base carrying one or a few replacement teeth, retained by wire clasps or the acrylic itself. The clasps, rests, and teeth are all included in the single fee.
The defining feature is its role in the treatment plan. A flipper carries the patient through a limited period (implant integration, extraction-site healing, or fabrication of a definitive partial or bridge) and is then retired. Bill D5820 when the upper arch is partially edentulous, a short-term removable prosthesis is delivered, and the treatment plan documents the definitive treatment to follow.
It does not cover:
- The lower-arch flipper. That’s D5821.
- An immediate upper partial delivered at extraction as the definitive prosthesis. That’s D5221 (resin base), D5223 (cast metal framework), or D5227 (flexible base).
- A definitive resin-base upper partial. That’s D5211.
- A definitive cast-metal upper partial. That’s D5213.
- A definitive flexible-base upper partial (Valplast-type). That’s D5225.
- An interim complete denture on a fully edentulous upper arch. That’s D5810.
- A one-piece unilateral partial replacing teeth on one side only. That’s D5284 (flexible base, per quadrant).
Interim versus immediate: the axis that gets miscoded
D5820 and D5221 can both describe an acrylic partial delivered the same day teeth come out. What separates them is the prosthesis’s role in the treatment plan:
- D5820, interim. Temporary by design. The plan of record continues to an implant crown, a bridge, or a definitive partial, and the flipper fills the gap. Delivery timing is irrelevant: seated at the extraction visit or two weeks later, it is still interim.
- D5221, immediate. Delivered at extraction as the patient’s definitive resin partial. Nothing further is planned for those teeth; the partial is relined after healing and stays.
The chart note settles it. A treatment plan reading “implant #8, flipper during integration” supports D5820. A plan that ends at the partial supports D5221. Code against the plan: a carrier reviewing a later implant-crown claim will read the earlier flipper claim in that light. An interim billed as an immediate can start the arch’s five-to-seven-year prosthesis frequency clock, which is plan-dependent but expensive to argue about later.
Coverage: verify the interim provision, not “partials”
Interim prostheses sit in their own benefit category on many plans, and outcomes vary widely:
- Covered as its own benefit, often at a modest allowable, sometimes with the missing-tooth clause applied.
- Excluded: “interim/temporary prostheses” listed as a plan exclusion.
- Bundled: the plan considers the interim prosthesis part of the definitive treatment’s fee and pays nothing separate.
A verification call that only confirms “partial dentures covered at 50%” doesn’t tell you which applies. Ask about interim or temporary prosthesis coverage by name, and quote the patient from the answer. On esthetic anterior cases the patient usually wants the flipper regardless, but they should hear the number before the lab does the work.
Top reasons D5820 gets denied
- Interim-prosthesis exclusion. The most common outcome on plans that don’t cover it. It is plan language, not appealable on clinical grounds. The defense is verification before the lab slip.
- Bundled into definitive treatment. The carrier pays the eventual implant crown or partial and considers the flipper included. This shows up as a denial with a “part of complete procedure” remark code.
- Missing-tooth clause. If the replaced tooth was extracted before the patient’s coverage began, plans that apply the clause to interim prostheses deny on it.
- Duplicative prosthesis. A definitive partial billed on the same arch within the plan’s frequency window after a paid D5820, or the reverse. Outcomes vary, so get a pre-treatment estimate on the definitive phase whenever a flipper is in the history.
- Coded against the wrong role. D5820 for what the record shows is a definitive immediate partial, or D5221 for a planned-temporary flipper. The mismatch surfaces when the carrier lines the claim up against the rest of the treatment plan.
Documentation that supports the claim
- The treatment plan showing the definitive phase the flipper is bridging. This is the most useful line in the record.
- Which teeth are replaced and their extraction dates, for the missing-tooth clause.
- Delivery date as the date of service, with the upper-arch designation.
- The expected wear period (“interim prosthesis during implant integration, estimated 4–6 months”).
- The patient’s signed estimate when coverage was verified as excluded or bundled.
Example case
A patient fractures tooth #9, and it is deemed non-restorable. The plan is to extract, place an implant after socket healing, and restore with a crown, roughly eight months end to end. She won’t go a week without a front tooth, so an upper flipper is made and seated at the extraction visit.
Billing steps:
- Verify interim-prosthesis coverage by name. This plan excludes interim prostheses, so the flipper will be patient-pay.
- Quote the flipper fee alongside the implant treatment plan, and get the signed estimate before impressions.
- Bill the extraction to the plan. Bill D5820 with the upper-arch designation on the flipper’s delivery date as a patient-responsibility line.
- Chart the flipper’s role explicitly: interim prosthesis during implant healing for #9.
- When the implant crown claim goes out months later, the flipper history reads as interim, with no prosthesis-frequency argument against the definitive restoration.
FAQs
- What is the dental code for a flipper tooth?
- D5820 for an upper flipper and D5821 for a lower one. The formal name is an interim partial denture: a short-term removable prosthesis, usually all acrylic, with any clasps, rests, and replacement teeth included in the single code. It is the standard stand-in during implant healing or while a definitive partial, bridge, or crown is fabricated.
- What's the difference between D5820 and D5221?
- Intent, not timing. D5820 is an interim prosthesis, planned from the start to be replaced by definitive treatment. D5221 is an immediate upper partial delivered the day of extractions as the patient's definitive resin-base partial. A flipper seated on extraction day is still D5820 if the treatment plan calls for an implant or definitive partial later. Code the role the prosthesis plays in the plan, and make sure the chart states it.
- Do dental plans cover flippers?
- Unevenly. Some plans pay D5820, often at a modest allowable. Others exclude interim prostheses entirely, or treat the flipper as part of the definitive prosthesis fee and pay nothing separate. A few apply the missing-tooth clause to it like any other partial. Verify the interim-prosthesis provision specifically, not just 'partial denture coverage,' before quoting the patient.
- Can I bill D5820 and then a definitive partial on the same arch?
- Often yes, because they serve different phases of treatment, but plan behavior varies. Some carriers pay both. Some deny the definitive partial or the flipper as duplicative. Some plans that paid D5820 apply the arch's prosthesis frequency clock to it, complicating the definitive partial claim later. Get a pre-treatment estimate on the definitive prosthesis when a paid flipper is already in the history.
- How long is a flipper meant to last?
- Months, not years: typically the span of implant integration or definitive-prosthesis fabrication, often three to twelve months. The all-acrylic construction and wire clasps aren't engineered for long-term function. If a patient ends up wearing one indefinitely, the record should show it was treatment-planned as interim. A flipper billed as D5820 but intended as the permanent prosthesis is a coding mismatch carriers can challenge.
Related codes
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CDT codes are maintained by the American Dental Association. This page is an editorial billing guide, not the official ADA code descriptor. Verify current coverage policies with each carrier before submitting claims.