When is D6060 used?
The D6060 dental code applies to an implant-supported porcelain fused to metal (PFM) crown with predominantly base metal composition. This code is utilized when a dental implant abutment supports a PFM crown where the metal framework consists primarily of base metals (like nickel-chromium or cobalt-chromium alloys). Apply D6060 for single implant restorations with PFM crowns, excluding natural teeth or bridge work. Verify that the abutment is positioned and the crown is being created and placed over an implant rather than a natural tooth. For different crown types or abutment materials, consult appropriate CDT codes, including D6058 for all-ceramic restorations or D6065 for high noble metal restorations.
D6060 Charting and Clinical Use
Accurate documentation ensures successful claim processing. Include these elements in patient records and insurance submissions:
Treatment notes explaining the necessity for implant-supported restoration (e.g., tooth loss, previous restoration failure).
X-rays demonstrating implant and abutment placement.
Clinical photographs of the implant area and final restoration.
Laboratory orders indicating PFM crown fabrication with base metal framework.
Timeline documentation of implant placement and abutment connection.
Typical applications for D6060 involve single-tooth implant restorations in both posterior and anterior areas where PFM crowns are selected for their strength and economic value.
Billing and Insurance Considerations
To optimize reimbursement and reduce claim rejections for D6060:
Confirm benefits prior to treatment by requesting comprehensive coverage details and verifying implant crown benefits with the insurance carrier.
Obtain pre-authorization when feasible. Submit pre-treatment estimates with supporting materials to determine coverage and patient financial responsibility.
Provide detailed descriptions in claims, clearly stating the crown is abutment-supported with predominantly base metal construction.
Include comprehensive documentation (x-rays, photographs, laboratory prescriptions) with claims. Incomplete documentation frequently causes claim denials.
Monitor benefit statements and respond quickly to denials or information requests.
Contest rejected claims using additional documentation and clear medical necessity explanations, citing the appropriate CDT code.
Maintaining organized and proactive billing procedures will enhance your practice's accounts receivable and minimize payment delays.
How dental practices use D6060
Clinical situation: A 52-year-old patient has a missing mandibular right first molar. An implant was installed three months prior and healing is complete. The dentist chooses a PFM crown with base metal framework for durability and cost-effectiveness. The abutment is positioned and the crown is manufactured and placed.
Processing steps:
Confirm insurance benefits for implant crowns and validate patient eligibility.
Record clinical observations, obtain radiographs, and capture site photographs.
Request pre-authorization including all supporting materials.
Following approval, place the crown and file the claim using D6060 with complete documentation.
Review benefit statements and promptly handle any issues or denials through appeals when needed.
This methodology ensures proper billing practices, reduces processing delays, and supports maximum reimbursement for dental practices.
Common Questions
Is D6060 applicable for crowns placed on natural teeth?
No, D6060 is exclusively designated for crowns supported by dental implant abutments, not for crowns placed directly on natural teeth. When placing crowns on natural teeth, different CDT codes must be utilized.
What are the primary causes of D6060 claim rejections?
Primary causes of D6060 claim rejections include inadequate documentation (missing radiographs or unclear clinical narratives), incorrect code usage for inappropriate materials or clinical situations, absence of required pre-authorization, or patients failing to meet insurance plan criteria for implant-supported crown coverage.
Do reimbursement rates vary between D6060 and comparable codes for high noble metal crowns?
Yes, reimbursement rates typically vary between D6060 (base metal) and codes designated for high noble metal crowns. High noble metal crowns generally involve higher material expenses and may receive increased reimbursement rates, making accurate code selection essential to properly reflect the materials utilized.