When is D6067 used?
The D6067 dental code applies to implant-supported metal-ceramic crowns that are placed on an implant abutment. This code is appropriate when a patient needs a single crown restoration supported by a dental implant rather than a natural tooth. It's crucial to differentiate D6067 from other implant crown codes, like D6065 (implant-supported porcelain/ceramic crown), to maintain proper billing practices and prevent claim rejections.
D6067 Charting and Clinical Use
Accurate documentation is critical when submitting claims for D6067. Patient records must clearly show:
Location and presence of the dental implant
Crown material specification (metal-ceramic)
Abutment attachment details
Before and after treatment radiographs
Comprehensive narrative explaining the clinical necessity for an implant-supported crown
Typical clinical situations involve patients missing a single tooth in either posterior or anterior areas where a metal-ceramic crown offers the ideal combination of durability and appearance. Make sure the clinical reasoning is thoroughly documented to support D6067 usage during insurance evaluations or practice audits.
Billing and Insurance Considerations
To optimize payment and reduce processing delays, implement these recommended practices when submitting D6067 claims:
Check patient coverage: Validate implant and crown benefits with the insurance carrier prior to treatment. Many policies have specific limitations or waiting periods for implant procedures.
Include comprehensive documentation: Attach patient records, radiographs, and detailed treatment narratives with your claim submission. This demonstrates medical necessity and decreases denial probability.
Select appropriate CDT codes: Verify that D6067 matches the restoration material and type. When different materials are used, choose the matching code.
Monitor EOBs and AR: Review Explanation of Benefits statements and accounts receivable regularly to quickly handle underpayments or claim denials. When claims are rejected, examine the insurer's explanation and file timely appeals with supplementary documentation.
Well-organized dental practices frequently employ verification checklists to confirm all necessary documentation accompanies claims before submission, minimizing reprocessing and enhancing revenue flow.
How dental practices use D6067
Patient: Jane Smith, missing tooth #30, healthy surrounding teeth.
Treatment: Installation of a titanium dental implant, followed by a custom abutment and a metal-ceramic crown.
Billing: Following coverage verification, the practice files a claim using D6067 for the crown, including before and after radiographs and a treatment narrative detailing the clinical necessity. The claim processes smoothly, and reimbursement arrives as anticipated.
This case demonstrates how proper code selection, complete documentation, and effective insurance coordination are essential when billing for implant-supported crowns with D6067.
Common Questions
What are the typical reasons insurance companies deny D6067 claims?
Several factors commonly lead to D6067 claim denials, including inadequate documentation such as missing radiographs or clinical narratives, incorrect CDT code selection for the specific material or procedure, failure to obtain required pre-authorization, or patient insurance plans that exclude implant-related treatments or specific crown types. To minimize denials, ensure comprehensive documentation and proper coding are submitted with each claim.
Is D6067 applicable for crowns on natural teeth or exclusively for implant crowns?
D6067 is exclusively designated for crowns supported by dental implants and cannot be used for crowns placed on natural teeth. Incorrect application of this code may lead to claim rejections or compliance audits. When placing crowns on natural teeth, the appropriate conventional crown codes should be selected instead.
How do base metals and noble metals differ in dental crowns, and how does this impact code selection?
Base metals, including nickel-chromium and cobalt-chromium alloys, offer cost-effectiveness along with excellent strength and durability characteristics. Noble metals, such as gold and palladium alloys, provide superior biocompatibility and corrosion resistance but come at a higher cost. The metal type directly influences CDT code selection: D6067 applies specifically to metal-ceramic crowns featuring a predominantly base metal substructure, while different codes are required for crowns containing noble or high noble metal compositions.