When is D6098 used?
The D6098 dental code applies to an "implant supported retainer for a porcelain/ceramic FPD (fixed partial denture)." This CDT code is appropriate when billing for the retainer component that holds a bridge (FPD) secured by a dental implant, not a natural tooth. This code covers specifically the retainer portion that connects to the implant and holds the bridgework, not the implant itself or the prosthetic crown. Apply D6098 only when the treatment involves a porcelain or ceramic fixed partial denture, and the retainer receives support from an implant abutment.
D6098 Charting and Clinical Use
Proper documentation is critical for successful reimbursement. When applying D6098, make sure that the clinical records clearly indicate:
The existence of a dental implant at the treatment site
The application of a porcelain/ceramic fixed partial denture
The particular retainer being installed and its attachment to the implant abutment
Supporting radiographs and intraoral photographs, when available
Typical clinical situations involve replacing a lost tooth with a bridge that receives support from implants instead of natural teeth. For instance, when a patient has lost a molar and both neighboring teeth are also missing or unsuitable as supports, implants are installed, and a porcelain FPD is created with implant-supported retainers at both ends. In this situation, D6098 applies to each retainer connected to an implant abutment.
Billing and Insurance Considerations
To improve claim approval and reduce processing delays, apply these recommended practices when billing D6098:
Confirm coverage: Prior to treatment, check with the patient's dental insurance to determine if implant-supported prosthetics and retainers receive coverage. Many policies include specific exclusions or restrictions for implant-related procedures.
Provide comprehensive documentation: Include clinical records, radiographs, and a description explaining why an implant-supported retainer is necessary. Emphasize why a conventional tooth-supported bridge is not viable.
Apply appropriate CDT codes: Combine D6098 with related codes when suitable, such as the code for implant placement (implant placement code) or the abutment (custom abutment code), to present a complete treatment overview.
Examine EOBs thoroughly: When a claim receives denial, review the Explanation of Benefits for the specific reason and prepare to file a claim appeal with supplementary documentation or explanation.
How dental practices use D6098
Take a patient who has lost teeth #19 and #20. Two implants are installed, and a porcelain FPD is created to restore both teeth. Each end of the bridge receives support from an implant abutment. In this case, D6098 is billed for each implant-supported retainer. The claim submission should contain:
Before and after treatment radiographs
Comprehensive clinical records describing the edentulous area and treatment approach
A description explaining why implant-supported retainers were required
Related codes for implant placement and abutments
By implementing these procedures, dental practices can maintain accurate billing, minimize claim rejections, and promote excellent patient care through proper documentation and code application.
Common Questions
Can CDT code D6098 be applied to implant-supported retainers fabricated with high noble metals?
No, CDT code D6098 is exclusively designated for implant-supported retainers constructed with porcelain fused to predominantly base metal materials. When dealing with retainers fabricated using high noble metals, practitioners must utilize an alternative CDT code that corresponds to the specific material composition.
Is CDT code D6098 suitable for billing single-unit implant crowns?
No, D6098 cannot be used for single-unit implant crowns. This code is specifically reserved for the retainer component of an implant-supported fixed partial denture (bridge system). When billing for single-unit implant crowns, practitioners should utilize appropriate codes such as D6065 for implant-supported porcelain or ceramic crowns.
What documentation is required when filing a claim using D6098?
Claims submitted with D6098 should include comprehensive clinical documentation such as detailed notes confirming implant support, specification of materials utilized in fabrication, pre-treatment and post-treatment radiographic images, a clinical narrative justifying treatment necessity, and thorough charting that illustrates the prosthetic design. Proper documentation ensures efficient claim processing and reduces the likelihood of claim rejections.