When is D6094 used?
The D6094 dental code applies to abutment-supported crowns, specifically when placing a crown over an implant abutment. This code should be used when the final restoration is a single crown supported by an implant abutment, rather than a natural tooth or bridge structure. It's important to distinguish D6094 from related codes like D6065 (implant-supported porcelain/ceramic crown) and D6057 (custom abutment), since each code represents different clinical situations and restoration types. Apply D6094 when the crown is cemented or screw-retained to either a prefabricated or custom abutment connected to the dental implant.
D6094 Charting and Clinical Use
Proper documentation is critical for successful D6094 billing. Dental practices must ensure patient records clearly show:
Confirmation of a dental implant at the treatment site
Documentation of abutment use (custom or prefabricated)
Clinical notes detailing crown placement on the abutment
Radiographic images or intraoral photographs showing the implant, abutment, and completed crown
Crown material specification (such as porcelain, ceramic, or metal)
Typical clinical situations include single-tooth implant restorations where the abutment and crown are placed during separate visits, or cases requiring custom abutment fabrication to achieve ideal aesthetics and function.
Billing and Insurance Considerations
To optimize reimbursement and reduce claim rejections for D6094, implement these strategies:
Check insurance benefits: Confirm the patient's dental plan includes implant-supported restoration coverage and identify any waiting periods or frequency restrictions.
Obtain pre-authorization: Submit pre-treatment estimates with supporting materials (radiographs, narratives, and chart documentation) to establish patient financial responsibility before beginning treatment.
Use proper coding: Apply D6094 exclusively when the crown is supported by an implant abutment. Avoid using this code for natural tooth crowns or implant crowns without abutments.
Include supporting materials: Provide clinical photographs, radiographs, and detailed narratives explaining why the abutment-supported crown is necessary.
Review EOBs carefully: Examine Explanation of Benefits statements thoroughly to confirm proper processing and payment. Submit appeals for denied claims quickly with additional documentation when required.
How dental practices use D6094
Practice Example: A patient comes in with a missing upper right first molar. Following implant placement and healing period, a custom abutment is created and attached to the implant. During a follow-up appointment, a porcelain crown is cemented to the abutment. The clinical documentation includes the implant location, abutment specifications, and crown material details. The practice submits a D6094 claim with before-and-after radiographs and includes a treatment narrative. The insurance company approves the claim and processes payment without complications.
This case demonstrates how proper documentation, accurate code usage, and clear insurer communication ensure smooth reimbursement for abutment-supported crown procedures.
Common Questions
How does D6094 differ from other implant crown codes such as D6065 or D6066?
D6094 is designated specifically for abutment-supported crowns, where the crown attaches to a separate abutment component that connects to the implant fixture. Other codes like D6065 (implant-supported porcelain/ceramic crown) and D6066 (implant-supported porcelain fused to metal crown) are applied when the crown connects directly to the implant without an intermediate abutment. Proper code selection is essential for accurate billing and avoiding insurance claim rejections.
Is D6094 appropriate for temporary abutments or provisional restorations?
D6094 is not suitable for provisional crowns or restorations placed on temporary abutments. This code applies exclusively to final, permanent crowns mounted on definitive abutments following complete implant osseointegration. Temporary or provisional restorations require different CDT codes and must be billed using the appropriate codes to prevent claim complications.
How should a dental practice handle insurance denials for D6094 claims when documentation appears complete?
When facing a D6094 claim denial, first examine the Explanation of Benefits to identify the specific denial reason. Verify that all necessary documentation including clinical records, radiographic images, and detailed narratives were properly submitted. If documentation is complete and appropriate, file a formal appeal including additional supporting evidence or clarification as needed. Maintaining persistent follow-up and clear payer communication often helps resolve denials and obtain proper reimbursement.