When is D6070 used?
The D6070 dental code applies to an abutment supported retainer for a porcelain fused to metal fixed partial denture (FPD), specifically when the metal component is primarily base metal. This CDT code is utilized when patients need a bridge (FPD) where the retainer (crown component) receives support from an implant abutment rather than a natural tooth. The restoration must consist of porcelain bonded to a base metal alloy, representing a practical and economical choice in restorative procedures. Apply D6070 when both the abutment and retainer are delivered during the same visit, and the materials and support structure align with the code specifications.
D6070 Charting and Clinical Use
Proper documentation remains crucial for successful claim processing and regulatory compliance. For D6070, make sure these elements are present in patient records:
Comprehensive clinical documentation outlining the edentulous area, implant positioning, and justification for an abutment-supported FPD.
Imaging studies or CBCT scans verifying implant location and osseointegration.
Material documentation specifying the use of porcelain bonded to primarily base metal alloy.
Laboratory documentation or work orders confirming the prosthesis type manufactured.
Typical clinical situations involve patients with missing teeth who have well-integrated implants and need bridge restoration for both function and appearance. When alternative materials are selected, such as high noble metal or full ceramic, use the corresponding CDT code, like D6067 for abutment supported retainer for porcelain fused to high noble metal FPD.
Billing and Insurance Considerations
Processing claims for D6070 demands careful attention to prevent rejections and processing delays. Consider these recommended practices:
Confirm insurance coverage prior to treatment, checking implant and prosthetic benefits, frequency restrictions, and waiting period requirements.
File pre-treatment estimates with supporting materials, including clinical documentation, imaging, and treatment proposals.
Apply exact CDT terminology on claims and include narratives when clinical circumstances are complicated or patients have previous prosthetic history.
Monitor EOBs (Explanation of Benefits) carefully and prepare to submit claim appeals with supplementary documentation if payment is denied or reduced.
Manage dual coverage when patients have multiple insurance plans, ensuring proper sequencing of primary and secondary submissions.
Complete and timely documentation, combined with proactive insurer communication, helps optimize reimbursement and reduce AR (accounts receivable) aging.
How dental practices use D6070
Case: A 58-year-old patient arrives with an absent mandibular first molar. A dental implant was previously placed and has achieved successful osseointegration. The treatment approach involves a three-unit FPD with the central pontic replacing the lost tooth, while the retainer receives support from the implant abutment. The restoration is constructed as porcelain fused to a base metal alloy, satisfying D6070 criteria.
Billing Process:
Record clinical observations, implant integration status, and material selection in patient documentation.
Collect and include pre- and post-treatment radiographs with the claim submission.
Process the claim using D6070, incorporating a narrative explaining clinical necessity and prosthesis specifications.
Monitor insurance carrier response, examine the EOB, and respond to any additional information requests quickly.
This methodology ensures regulatory compliance, demonstrates medical necessity, and facilitates efficient reimbursement for dental practices.
Common Questions
Do most dental insurance plans provide coverage for D6070?
Insurance coverage for D6070 differs significantly between plans. Many dental insurance policies do not include comprehensive benefits for implant-supported restorations or specific materials such as base metal components. Before proceeding with treatment, it is crucial to review the patient's specific insurance plan details to confirm whether D6070 is covered, identify any frequency restrictions, or determine if particular materials are excluded from coverage.
Is D6070 applicable for repairing or replacing existing implant-supported retainers?
D6070 cannot be used for repairs or replacements of existing implant-supported retainers. This code is specifically designated for the initial placement of an abutment-supported retainer for a porcelain fused to metal fixed partial denture (FPD) with predominantly base metal construction. When dealing with repairs or replacements of existing retainers, different CDT codes must be utilized based on the specific type of service being performed. Reference the most current CDT manual to identify the correct code for repair or replacement procedures.
How do D6070 and D6071 differ from each other?
The primary difference between D6070 and D6071 lies in the metal composition of the retainer. D6070 applies to abutment-supported retainers for porcelain fused to metal FPDs constructed with predominantly base metal materials. D6071, however, is designated for retainers fabricated using noble metal materials. This material distinction plays a critical role in accurate clinical documentation and proper insurance billing procedures, as coverage policies and reimbursement rates often vary depending on the specific materials utilized in the restoration.