Resources for dental offices
Dental billing codes trip up even experienced office managers. If your practice has been submitting claims for bridges or you're trying to understand your patient's treatment plan, you've probably encountered code D6245. This code covers a specific type of bridge component—a porcelain-fused-to-metal pontic—and knowing when and how to use it correctly helps avoid claim denials and keeps your practice running smoothly. This article breaks down what dental code D6245 means, when it applies, and what you need to know about billing and documentation.
Oct 25, 2025
What is Dental Code D6245?
The American Dental Association (ADA) defines D6245 as a pontic made from porcelain fused to a predominantly base metal framework. A pontic is the artificial tooth that fills the gap in a fixed bridge. The base metal framework provides strength while the porcelain overlay delivers a natural appearance. This combination balances function with appearance, making it a common choice for posterior bridges where chewing forces are strongest.
You might hear D6245 referred to as a PFM pontic, a porcelain-fused-to-metal pontic, or simply a base metal pontic. All these terms point to the same restoration. The "predominantly base metal" distinction is key; it means the metal substructure contains primarily non-noble metals like nickel-chromium or cobalt-chromium rather than high-noble metals like gold or platinum.
When is D6245 Used?
D6245 comes into play whenever you're replacing a missing tooth with a fixed bridge that uses a porcelain-fused-to-base-metal pontic. You'll submit this code in several situations:
Multi-unit bridges: When fabricating a three-unit bridge (two abutments and one pontic) to replace a single missing tooth
Longer span bridges: For bridges spanning multiple missing teeth, with each pontic billed separately using D6245
Posterior replacements: Most commonly used for molars and premolars where strength matters more than the highest level of appearance
Cost-conscious cases: When patients need durable restorations but want to manage treatment costs
When D6245 is NOT Appropriate
Knowing when not to use D6245 is just as important as knowing when to use it. Using the wrong code leads to claim denials, payment delays, and frustrated patients. Understanding what D6245 doesn't cover prevents billing errors and keeps your practice running efficiently. This code shouldn't be used in several situations:
All-porcelain pontics: If the pontic contains no metal substructure, use D6242 instead
High-noble metal pontics: Pontics with predominantly noble metals (gold, platinum, palladium) fall under D6244
Noble metal pontics: When the metal content is at least 25% noble but not predominantly high-noble, D6214 applies
Implant-supported restorations: Implant crowns and bridges use different coding categories entirely
Removable partial dentures: These prosthetics have their own set of codes and don't involve pontics in the fixed bridge sense
Billing and Insurance Considerations
Strong documentation protects your practice when submitting D6245 claims. Your clinical records need to paint a complete picture of why this treatment was necessary and how you delivered it. Include clinical notes that describe the condition of adjacent teeth, the reason for tooth loss, and why a fixed bridge was chosen over other options. Radiographic documentation should show the prepared abutment teeth, bone levels, and the pontic site. You'll also want periodontal charting that demonstrates adequate bone support for the bridge and any relevant photos showing the prepared teeth or the finished restoration.
Most dental insurance plans cover D6245 as a major restorative procedure, but coverage details vary widely. Plans typically cover 50% of the allowed amount after your patient meets their annual deductible. Some plans impose waiting periods—often 12 months from the policy start date—before covering major work like bridges. Annual maximums also come into play since bridges can easily consume a large portion or all of the yearly benefit. Pre-authorization is worth pursuing for any bridge case. Submit the treatment plan with supporting documentation before starting work to confirm coverage and avoid surprises.
Small errors in coding or documentation can delay payment or trigger denials. Watch out for these frequent mistakes:
Missing tooth clause confusion: Many plans won't cover replacing a tooth that was missing before the patient enrolled, so verify the timeline of tooth loss
Incorrect material designation: Mixing up D6245 with D6244 or D6214 because of confusion about metal content leads to claim rejections
Incomplete documentation: Submitting claims without adequate radiographs or clinical notes gives insurance companies a reason to deny or downcode
Billing all units at once: Some practices accidentally bill multiple pontics under a single code entry instead of itemizing each pontic separately
Overlooking lab codes: Forgetting to include separate laboratory fees when your plan allows it means leaving money on the table
Common Questions
How often can D6245 be billed for the same site?
Insurance plans typically allow one pontic per site per five years, though some extend this to seven or even ten years. If a bridge fails prematurely, you'll need to provide documentation explaining why replacement is necessary before the standard timeframe has passed. Plans usually don't limit the number of pontics you can bill in different sites during the same treatment episode, so a patient receiving two separate bridges can have both covered if benefits allow.
Why did insurance approve the abutment crowns but question the pontic?
The most common source of confusion is the difference between porcelain-fused-to-metal codes. Patients don't always grasp that D6245 refers specifically to base metal frameworks, and using a different metal composition means a different code and potentially different coverage. Another frequent issue is the missing tooth clause—patients are surprised to learn their plan won't cover replacing a tooth they lost years ago, before they had this insurance.
Does D6245 apply to anterior pontics or just posterior teeth?
The code itself doesn't restrict use by location. You can bill D6245 for a pontic in an anterior position, though appearance considerations might lead you to choose an all-ceramic option in the front of the mouth. The code describes the material composition, not the tooth location.
How do I bill a bridge with pontics made from different materials?
Bill each pontic with its appropriate code based on its actual composition. If one pontic uses porcelain-fused-to-base-metal and another uses all-ceramic, you'll submit D6245 for the first and D6242 for the second. The bridge as a whole gets billed as separate components: each abutment crown receives its own code (D6750, D6751, etc.) and each pontic gets coded individually.
What's the difference between replacing a pontic and repairing one?
If you're replacing a previously placed pontic completely, use D6245. Repairs to existing pontics require different codes depending on the type of repair needed. Check whether you're doing a complete replacement or a repair before submitting your claim.
Getting D6245 Right
D6245 is straightforward once you understand what it covers and how to document it properly. Getting the details right—from choosing the correct code to providing thorough clinical notes—protects your revenue and helps patients receive the coverage they've earned.
Managing dental hygiene staffing shouldn't be as complicated as mastering billing codes. Teero connects your practice with qualified hygienists who can step in when you're short-staffed, so you can keep your patient schedule full and your team focused on care. Whether you need coverage for a few shifts or you're looking to bring on a permanent team member, Teero takes care of the hiring complexities while you keep your practice running. Sign up for Teero today and find the best hygienists for your practice.