When is D6096 used?
The D6096 dental code applies to the extraction of a fractured implant retaining screw. This CDT code should be utilized when a patient has a dental implant with a broken screw that connects the prosthetic component to the implant fixture and needs removal. It's crucial to understand that D6096 covers only the extraction of the damaged screw; it excludes screw replacement or additional prosthetic procedures. Apply this code when dealing with a broken or damaged retaining screw that standard retrieval methods cannot remove and requires a distinct, billable treatment.
D6096 Charting and Clinical Use
Proper documentation is critical for successful claim processing and regulatory compliance. When submitting claims for D6096, make sure your clinical records clearly include:
The location and presence of the fractured implant retaining screw
The justification for removal (e.g., screw breakage, standard tool retrieval failure)
The removal method employed (e.g., ultrasonic device, reverse-torque tool)
Any procedural complications that occurred
Post-treatment care or suggestions
Typical situations involve patients with implant-retained crowns or bridges experiencing loosening or complications from a broken screw. In such instances, D6096 should be documented alongside any follow-up treatments, such as screw or prosthesis replacement, which may be coded under different CDT codes like D6199 (miscellaneous implant service).
Billing and Insurance Considerations
To optimize reimbursement and reduce claim rejections for D6096, implement these recommended practices:
Confirm benefits: Many dental insurance plans exclude implant-related treatments. Check coverage details and restrictions prior to treatment.
Provide comprehensive narratives: Include a detailed, straightforward explanation of why screw extraction was required and the method used. Add radiographic images or clinical photographs when possible.
Apply proper CDT coding: Avoid combining D6096 with other implant treatments unless the insurance company specifically allows it. Code each service individually when clinically appropriate.
Examine EOBs: Thoroughly review Explanation of Benefits documents for payment correctness and rejection explanations. When claims are denied, use your documentation to support appeals.
Monitor AR: Keep track of accounts receivable for pending claims and address any problems quickly.
How dental practices use D6096
Clinical Example: A 58-year-old patient reports pain and looseness in an implant-retained posterior crown. Clinical assessment and X-rays reveal a broken retaining screw inside the implant fixture. The dentist tries removal using conventional instruments without success. A specialized extraction system is used to carefully remove the fractured screw while preserving the implant integrity. The treatment is thoroughly documented with before and after photographs. The practice submits D6096 for the screw extraction along with comprehensive supporting materials to the insurance provider. The claim receives approval, and payment is processed within the typical accounts receivable timeframe.
This case demonstrates the significance of accurate coding, complete documentation, and effective insurance coordination when incorporating D6096 into your dental practice billing procedures.
Common Questions
Is there an additional charge for the replacement screw when using code D6096?
Yes, code D6096 exclusively covers the removal of the fractured implant retaining screw. When a replacement screw or additional restorative procedures are needed, these services must be billed separately using the corresponding CDT codes. It's recommended to verify with the patient's insurance provider regarding coverage for replacement components or subsequent procedures.
Are general dentists permitted to bill D6096, or is this code restricted to specialists only?
General dentists are authorized to bill D6096 provided they possess the necessary training and equipment to perform the procedure safely. This code is not exclusively reserved for specialists; however, thorough documentation and compliance with clinical standards are crucial for claim approval regardless of the provider's specialty.
What information should be included in the narrative when filing a D6096 claim?
An effective narrative for D6096 should contain a clear description of the clinical problem (such as a broken retaining screw), the procedural steps performed to remove the screw, the implant's condition following removal, and any pertinent supporting documentation including radiographs or intraoral photographs. This comprehensive information helps demonstrate the procedure's medical necessity and strengthens the reimbursement claim.