When is D6087 used?
The D6087 dental code applies to an implant supported crown that functions as an abutment supported retainer within a fixed partial denture. This code is appropriate when a dental implant has been placed and the final restoration consists of a crown supported by an abutment rather than directly by the implant. It's essential to differentiate D6087 from other implant crown codes like D6065 (implant supported porcelain/ceramic crown) or D6068 (abutment supported metal crown), since each code reflects distinct clinical situations and prosthetic approaches. Selecting the appropriate code helps ensure proper billing and reduces the likelihood of claim rejections.
D6087 Charting and Clinical Use
Thorough documentation is essential when filing claims for D6087. Clinical records must clearly document:
The existence of a dental implant with an abutment component.
The specific prosthesis being provided (crown serving as part of a fixed partial denture/bridge).
X-ray documentation confirming proper implant and abutment placement.
Information about materials utilized and clinical justification for selecting an abutment-supported crown.
Typical clinical situations involve patients with multiple missing teeth where a fixed partial denture (bridge) relies on implants and abutments for support. In such cases, D6087 applies to the retainer crown component positioned on the abutment, distinct from the pontic or implant fixture itself.
Billing and Insurance Considerations
To optimize reimbursement and minimize processing delays, implement these recommended practices when billing D6087:
Confirm benefits: Prior to treatment, validate the patient's implant and prosthetic coverage, including any frequency restrictions and waiting periods.
Obtain pre-approval: File a pre-treatment estimate with supporting materials to prevent unexpected issues for the practice and patient.
Precise coding: Apply D6087 exclusively for abutment-supported retainer crowns within fixed partial dentures. Utilize alternative codes, such as implant supported porcelain/ceramic crown, when clinically indicated.
Include supporting materials: Consistently provide clinical documentation, X-rays, and comprehensive narratives explaining the medical necessity of the abutment-supported crown.
Monitor EOBs: Thoroughly examine Explanation of Benefits statements for payment correctness and prepare to file appeals with supplementary documentation if claims face denial.
How dental practices use D6087
A 58-year-old patient arrives with two absent lower molars. Following implant insertion and osseointegration, the dentist creates a fixed partial denture (bridge) anchored by two implants. Each implant receives an abutment, and the bridge incorporates two retainer crowns (positioned on each abutment) plus a pontic. The practice bills D6087 for the retainer crowns, submitting X-rays and a narrative outlining the clinical situation. The insurance carrier evaluates the claim, recognizes the comprehensive documentation, and authorizes payment for both D6087 crowns as components of the fixed partial denture.
Through proper understanding of when and how to apply the D6087 dental code, dental practices can maintain accurate billing practices, reduce claim rejections, and deliver excellent patient care.
Common Questions
Can code D6087 be submitted multiple times when several provisional crowns are required throughout the implant treatment?
Code D6087 should typically be billed only once per implant site during the provisional crown phase. When a provisional crown requires replacement or remaking due to treatment complications or extended healing periods, thorough documentation and clear justification of medical necessity must be provided. Many insurance providers may deny reimbursement for multiple provisional crowns at the same implant location, so it's essential to verify coverage details and establish communication with the payer prior to submitting subsequent claims.
Does D6087 apply to provisional implant crowns in both front and back teeth?
Code D6087 is appropriate for provisional implant crowns in both anterior and posterior locations, provided the restoration is abutment-supported and serves as a temporary solution. The documentation standards and clinical justification requirements are consistent regardless of which tooth position is being treated.
How does an abutment-supported provisional crown (D6087) differ from a screw-retained provisional crown?
Code D6087 applies specifically to provisional crowns that are supported by an implant abutment, whether they are cemented or screw-retained to that abutment. The critical distinction is that the provisional restoration is placed on an abutment rather than directly onto the implant fixture. When the provisional is placed directly on the implant without an intermediate abutment, a different CDT code would be more appropriate. Careful review of the clinical situation and CDT code descriptions ensures proper coding accuracy.