When is D6064 used?
The D6064 dental code is utilized for billing an implant-supported cast metal crown made from noble metal materials in dental practice. This CDT code is appropriate when a patient receives a crown constructed primarily from noble metal alloys like gold, palladium, or platinum that is placed on a dental implant abutment. It's important to differentiate D6064 from related implant crown codes, including D6065 (porcelain/ceramic crown) or D6062 (high noble metal), for proper billing and payment processing. Apply D6064 specifically when the crown is made from noble metal alloys (not high noble or base metals) and is attached to an implant abutment rather than a natural tooth.
D6064 Charting and Clinical Use
Accurate record-keeping is essential for successful D6064 claims processing. Make sure the patient's clinical records clearly document:
Confirmation of a dental implant and abutment present at the restoration site
Crown material specifications (noble metal type with specific alloy information)
Before and after radiographic images showing the implant and abutment placement
Treatment notes explaining the rationale for selecting a cast metal crown (such as heavy bite forces, patient request, or sensitivity to alternative materials)
Typical clinical applications for D6064 include restoring back tooth implants where maximum strength and longevity are essential, or when patients specifically choose noble metal restorations due to compatibility considerations.
Billing and Insurance Considerations
To optimize payment and reduce claim rejections for D6064, implement these recommended practices:
Check coverage: Prior to treatment, validate the patient's implant and crown benefits, yearly limits, and timing restrictions with their insurance provider.
Obtain approval: Send a comprehensive pre-treatment plan with supporting materials, including X-rays and detailed explanation, to secure written authorization.
Submit claims: Apply the appropriate CDT code (D6064) and include all necessary documentation—X-rays, treatment records, and laboratory receipts confirming noble metal composition.
Track progress: Monitor claim processing, review benefit statements for correctness, and prepare to file appeals with supplementary documentation if claims are rejected or reduced.
Effective dental practices create standardized procedures for implant crown billing and educate their administrative staff on CDT code specifics to prevent typical mistakes, including incorrect material coding or confusion between implant-supported and tooth-supported restorations.
How dental practices use D6064
Take a patient who lost a lower first molar and received a dental implant with a custom abutment. The dentist suggests a cast noble metal crown because the patient grinds their teeth and wants a strong, body-friendly material. The practice checks implant crown benefits, sends a pre-approval request with X-rays and explanation, and gets authorization. After placing the crown, the billing staff files a claim with D6064, includes the lab receipt showing the noble metal type, and tracks the claim until payment arrives. This organized method ensures proper reimbursement and positive patient satisfaction.
Common Questions
What documentation is required when submitting a claim for D6064?
For D6064 claims, submit comprehensive clinical notes that detail the abutment support and specify the noble metal material type, include radiographs demonstrating proper implant placement, provide a detailed narrative justifying the medical necessity for a noble metal crown, and attach the laboratory invoice verifying the materials used. Complete documentation strengthens your claim and minimizes denial risks.
How should dental practices manage cases where patient insurance doesn't cover D6064?
When insurance coverage is unavailable for D6064, maintain clear patient communication prior to treatment initiation. Present a detailed pre-treatment estimate outlining the patient's out-of-pocket expenses, explore various payment plan options, and provide information about available third-party financing solutions when applicable. Open communication enables informed patient decision-making and prevents future payment complications.
What are the most frequent coding mistakes to avoid with D6064 billing?
Frequent coding mistakes include incorrectly using D6064 instead of codes for porcelain-fused-to-metal or base metal crowns. Always confirm that clinical documentation and laboratory invoices align with D6064 specifications—ensuring the crown is properly abutment-supported and constructed from noble metal materials. Thorough verification of these critical details prior to claim submission prevents denials and processing delays.