When is D6063 used?
The D6063 dental code applies to an abutment supported cast metal crown (predominantly base metal). This CDT code is utilized when a patient receives a crown made primarily from base metals (like nickel-chromium or cobalt-chromium alloys) that rests on a dental implant abutment. It's crucial to differentiate D6063 from other implant crown codes, including those for porcelain fused to metal or all-ceramic restorations, to maintain proper billing and clinical records. Apply D6063 exclusively when the crown is cast metal and the abutment is prefabricated or stock rather than custom-made.
D6063 Charting and Clinical Use
Thorough documentation is vital for successful claim processing and payment. When applying D6063, include these elements in the patient file:
Comprehensive chart notes outlining the clinical necessity for an implant-supported cast metal crown
X-ray documentation showing implant and abutment positioning
Material details confirming the crown is mainly base metal
Before and after photographs when possible
Typical clinical applications for D6063 include posterior implant restorations where appearance is secondary, patients with sensitivities to noble metals, or situations requiring budget-conscious solutions. Always verify the crown type and abutment correspond to the code requirements to prevent claim rejections.
Billing and Insurance Considerations
To maximize reimbursement, implement these strategies:
Coverage Verification: Check the patient's implant benefits, yearly limits, and timing restrictions prior to treatment. Numerous plans include specific exclusions or waiting periods for implant-supported crowns.
Proper Coding: Verify that D6063 is the correct code choice. If the crown is porcelain fused to metal, consider the code for abutment supported porcelain/ceramic crown alternatively.
Supporting Materials: Include relevant documentation (X-rays, laboratory material receipts, clinical records) with the original claim to minimize requests for extra information.
EOB Analysis: Thoroughly examine the Explanation of Benefits for any reductions or rejections. If payment is lower than anticipated, prepare an appeal with additional documentation and a letter explaining treatment necessity.
Claims Management: Monitor pending claims and maintain regular contact with insurance providers to address delays and secure prompt payment.
How dental practices use D6063
A 58-year-old patient arrives with a missing lower right first molar. Following implant insertion and recovery, a standard abutment is placed, and a cast metal crown (mainly base metal) is created and installed. The dental staff records the implant and abutment positioning with X-rays, provides a laboratory receipt showing the crown composition, and creates a treatment note explaining the base metal selection for strength and affordability. The claim is filed with complete supporting materials using D6063. The insurance provider approves the claim promptly, and reimbursement is received according to the patient's coverage terms.
By implementing these procedures and ensuring proper application of D6063, dental offices can improve billing efficiency, reduce claim denials, and deliver excellent patient treatment.
Common Questions
Can code D6063 be applied to crowns fabricated from noble or high noble metal alloys?
No, D6063 is exclusively designated for abutment supported cast metal crowns composed predominantly of base metal materials. When the crown is constructed from noble or high noble metal alloys, alternative CDT codes must be utilized, specifically D6061 or D6062, which are appropriately designated for those premium materials.
Does D6063 apply to both cement-retained and screw-retained implant crown restorations?
Yes, D6063 is applicable for both cement-retained and screw-retained implant crowns, provided the restoration qualifies as an abutment supported cast metal crown made predominantly of base metal and features a separate abutment component from the crown. The specific retention methodology should be properly documented in the patient's clinical records for comprehensive treatment documentation.
What essential elements should be incorporated in a narrative when filing a claim using D6063?
An effective narrative for D6063 should encompass the clinical justification for choosing a cast metal crown restoration (including factors such as significant occlusal forces or relevant patient history), verification that the crown material is predominantly base metal, detailed description of the implant system and abutment components, and any pertinent patient-specific considerations. Additional supporting documentation including radiographic images and laboratory invoices should be appropriately referenced within the narrative.