When is D6062 used?
The D6062 dental code applies to an abutment supported cast metal crown made from high noble metal. This CDT code is appropriate when placing a crown on a dental implant that is crafted from high noble metal materials and supported by an abutment. It's crucial to differentiate D6062 from related codes, including those for porcelain-fused-to-metal or base metal restorations, to ensure proper billing and prevent claim rejections. Apply D6062 exclusively when the crown consists of high noble metal materials (such as gold, platinum, or palladium alloys) and is positioned on an implant abutment, not on a natural tooth structure.
D6062 Charting and Clinical Use
Accurate documentation is crucial for successful reimbursement of D6062. Clinical records must clearly document:
The existence of a dental implant and its abutment.
The crown material specification (particularly high noble metal composition).
Radiographic images or intraoral photographs verifying implant and abutment positioning.
A clinical narrative explaining the medical necessity for high noble metal crown selection, including patient-specific metal sensitivities or functional needs.
Typical clinical situations involve patients with posterior implants needing enhanced durability or individuals with documented metal sensitivities requiring high noble alloy materials. Always verify that your documentation aligns with the clinical circumstances to justify D6062 usage.
Billing and Insurance Considerations
Optimizing reimbursement for D6062 demands careful attention to process:
Confirm benefits: Prior to treatment, validate the patient's implant and crown coverage, including potential downgrades to base metal options or frequency restrictions.
Provide comprehensive narratives: When filing claims, include detailed justification for high noble metal selection and attach relevant documentation (radiographs, photographs, clinical notes).
Apply appropriate CDT codes: Confirm you're not mixing D6062 with codes for natural tooth crowns or alternative implant-supported restorations, such as D6065 for porcelain-fused-to-metal restorations.
Monitor EOBs: Examine explanation of benefits statements quickly. When claims face denial or downgrade, prepare appeal submissions with supplementary documentation.
Effective dental practices establish procedures for insurance verification, pre-authorization, and claim follow-up regarding implant-supported restorations. Staff training on these processes can decrease accounts receivable days and enhance collections.
How dental practices use D6062
Case: A 55-year-old patient arrives with an absent mandibular molar. Following implant placement and osseointegration, a custom abutment is installed. Given the patient's grinding habit and documented metal sensitivities, the dentist suggests a cast high noble metal crown for superior durability and biocompatibility. Clinical documentation includes the treatment rationale, and radiographic images are provided. The claim submission includes D6062, explanatory narrative, and supporting records. Insurance initially reduces payment to base metal crown level, but following a prompt appeal with additional evidence, the claim receives approval for the high noble metal restoration.
This case demonstrates the significance of thorough documentation, accurate code application, and persistent follow-up in optimizing D6062 reimbursement.
Common Questions
What qualifies as a high noble metal for D6062 dental crowns?
High noble metal alloys used in D6062 crowns must contain a minimum of 60% noble metals, with at least 40% being gold content. Typical examples include gold, platinum, and palladium-based alloys. These premium materials are selected for their exceptional longevity, excellent biocompatibility, and outstanding corrosion resistance, making them particularly well-suited for implant-supported restorations.
Is the D6062 code applicable for crowns placed on natural teeth?
No, the D6062 code is exclusively designated for abutment-supported crowns placed on dental implants, not for natural teeth. When placing crowns on natural teeth, different CDT codes must be utilized that correspond to the specific crown type and the condition of the natural tooth being restored.
What out-of-pocket expenses might patients expect with D6062 procedures?
Out-of-pocket expenses for D6062 procedures vary significantly based on the patient's specific dental insurance coverage. Many insurance plans provide different reimbursement rates for high noble metal crowns compared to base metal alternatives, and some may impose frequency restrictions on coverage. It's essential to verify insurance benefits and thoroughly discuss potential costs with patients prior to beginning treatment.