D5225 dental code: maxillary flexible base partial denture.

D5225 is the CDT code for an upper partial denture with a flexible base, including the retentive and clasping materials, rests, and teeth. It describes a maxillary removable partial made from a flexible resin such as a nylon-type thermoplastic, often called a Valplast-type partial. The lower arch version is D5226.

Last updated June 2026 · Reviewed by the PracticeAlpha billing team

Code
D5225
Category
Prosthodontics
Arch
Maxillary (upper)
Base
Flexible resin

When to use D5225

Use D5225 when delivering an upper removable partial denture made with a flexible base material. The code covers the whole appliance: the flexible base, the retentive and clasping materials, the rests, and the replacement teeth. It applies to the maxillary arch only. The lower arch equivalent is D5226.

Common clinical scenarios: A patient missing several upper teeth who wants a lighter, metal-free partial. A patient with sensitivity to or aesthetic concerns about visible metal clasps. A patient who needs a comfortable, flexible appliance to replace one or more missing maxillary teeth. Cases where the practitioner has chosen a nylon-type thermoplastic over a cast metal framework.

Do NOT use D5225 for: Lower flexible partials (use D5226). Maxillary partials built on a cast metal framework (use D5213). Maxillary partials with a resin base and no flexible material (use D5211). Complete upper dentures (use D5110). Billing the clasps, rests, or teeth separately, since they are already included in D5225.

Why D5225 claims get denied

Frequency limitation

Most plans replace a partial denture only after a set number of years. If the patient received a partial in the same arch within that window, the claim gets denied regardless of how the current one is fitting. Check the patient history before treatment. If a replacement is needed early, submit a narrative explaining why, such as loss, damage beyond repair, or significant changes in the arch.

Insufficient documentation of missing teeth

Payers want to see which teeth are missing and that a partial is justified. Current radiographs of the edentulous areas and a charted list of missing teeth are baseline. A claim without them can be denied or pended for records. Document the arch, the missing teeth, and the clinical rationale for a flexible base partial.

Material mismatch

D5225 is specifically a flexible base partial. If the lab actually fabricated a cast metal framework partial and the claim shows D5225, that is a coding error and an audit trigger. The delivered appliance has to match the code. A cast metal maxillary partial is D5213, not D5225.

Billed before delivery

Many plans pay on the seat or delivery date, not the impression date. If the claim is submitted at the impression appointment, it can be denied as premature. Confirm the plan's date-of-service rule for removable prosthetics and bill on the date the partial is actually delivered to the patient.

Documentation checklist for D5225

Charted missing teeth

List the missing maxillary teeth the partial is replacing. A clear charting of the edentulous spaces shows the appliance is appropriate and supports the number of teeth on the partial.

Current radiographs

Include recent images of the edentulous areas and the abutment teeth. These confirm the arch condition and the suitability of the remaining teeth to support a removable partial.

Material documentation

Confirm the appliance is a flexible base partial. The lab slip should reflect a flexible resin material. If it shows a cast metal framework, the correct code is D5213, not D5225.

Arch confirmation

Document that the appliance is maxillary. D5225 is the upper arch code. A mandibular flexible partial is reported with D5226, so the note and claim need to agree on the arch.

Delivery date and pre-authorization

Record the date the partial was delivered, since many plans pay on the seat date. If the plan requires pre-authorization, document the pre-auth number and include it on the claim.

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Related denture and partial codes

D5226 Mandibular partial denture, flexible base (lower arch version)
D5211 Maxillary partial denture, resin base
D5213 Maxillary partial denture, cast metal framework with resin bases
D5212 Mandibular partial denture, resin base
D5214 Mandibular partial denture, cast metal framework with resin bases
D5110 Complete denture, maxillary
D5630 Repair or replace broken retentive clasping materials, per tooth

D5225 FAQ

What is D5225 dental code?

D5225 is the CDT code for a maxillary partial denture with a flexible base, including any retentive and clasping materials, rests, and teeth. It describes an upper removable partial made from a flexible resin material such as a nylon-type thermoplastic.

What is the difference between D5225 and D5226?

D5225 is a flexible base partial denture for the upper arch. D5226 is the same type of appliance for the lower arch. The arch determines the code. Use D5225 for maxillary and D5226 for mandibular.

What is the difference between D5225 and D5213?

D5225 is a maxillary partial with a flexible resin base. D5213 is a maxillary partial with a cast metal framework and resin denture bases. The framework material is the difference. Flexible base is reported with D5225, cast metal with D5213.

Why do D5225 claims get denied?

Common reasons: missing or undated radiographs of the edentulous areas, frequency limitations on partial dentures, the appliance billed before delivery on some plans, and material not matching the code when a cast metal partial was actually delivered.

Are the clasps and teeth billed separately from D5225?

No. D5225 already includes the retentive and clasping materials, the rests, and the teeth. They are part of the partial denture and should not be reported with separate codes. Billing the components separately is an unbundling error.

Does D5225 require pre-authorization?

Many plans require pre-authorization for removable partial dentures. Check the patient's plan before treatment. Submitting a pre-auth with current radiographs, the missing teeth charted, and a treatment narrative reduces denials and surprise balances.

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