When is D6112 used?
The D6112 dental code applies to an implant/abutment supported removable denture for a partially edentulous maxillary arch. This CDT code covers situations where a patient has lost some, but not all, upper teeth (maxillary arch) and needs a removable prosthetic device supported by implants or abutments. Apply D6112 when the denture can be removed by the patient and is secured by dental implants, providing better retention and functionality than conventional tissue-supported dentures.
It's crucial to differentiate D6112 from related codes, such as D6114 (implant/abutment supported fixed denture for a completely edentulous arch) or D6110 (conventional removable denture for a completely edentulous arch), to guarantee proper coding and payment.
D6112 Charting and Clinical Use
Accurate documentation is vital for successful claims processing and regulatory compliance. For D6112, clinical records should contain:
Diagnosis of partial tooth loss in the maxillary arch
Pre-treatment radiographs and intraoral photographs displaying remaining teeth and implant locations
Treatment plan specifics, including implant/abutment quantity and positioning
Type of removable prosthetic device created
Materials utilized and retention system (e.g., locator attachments, bars)
Patient consent and comprehension of removable characteristics
Typical clinical situations involve patients with deteriorating upper teeth who maintain some natural dentition and need enhanced stability and function beyond what a standard partial denture offers. D6112 is also suitable when implants are strategically positioned to support a removable prosthetic, particularly in cases with compromised ridge structure.
Billing and Insurance Considerations
Processing claims for D6112 demands careful attention. Here are practical steps for optimizing reimbursement:
Confirm coverage: Prior to treatment, perform comprehensive insurance verification to validate benefits for implant-supported removable prosthetics. Many plans exclude implant services, so secure written predetermination whenever feasible.
Provide supporting materials: Always include clinical documentation, radiographs, and a detailed explanation of medical necessity for an implant-supported removable denture. Emphasize why a standard partial is inadequate.
Apply accurate CDT codes: Combine D6112 with relevant procedure codes (e.g., implant placement, abutment connection) as needed, ensuring each code has proper documentation support.
Track EOBs and AR: Examine Explanation of Benefits (EOBs) quickly for rejections or downgrades. When claims are denied, respond with a comprehensive appeal letter citing documentation and clinical reasoning.
Effective dental practices establish standardized procedures and educate staff to understand the complexities of implant-supported prosthetic billing.
How dental practices use D6112
Case: A 62-year-old patient arrives with multiple missing upper teeth and remaining teeth showing poor prognosis. Following extractions, four implants are installed in the maxillary arch. A removable denture featuring locator attachments is constructed, giving the patient enhanced function and comfort.
Billing process:
Confirm the patient's insurance benefits for implant-supported dentures and secure predetermination.
Record the patient's partial tooth loss, implant installation, and justification for a removable prosthetic.
Process the claim using D6112, including all supporting materials and a detailed narrative.
Examine the EOB, and when needed, file an appeal with additional clinical evidence.
This method ensures proper coding, optimizes payment, and addresses the patient's clinical requirements.
Common Questions
How do dental codes D6112 and D6111 differ?
D6112 applies to implant/abutment supported removable dentures for partially edentulous maxillary (upper) arches, whereas D6111 is specifically for completely edentulous maxillary arches. Use D6111 when all upper teeth are absent and an implant-supported removable denture is being provided.
What are the age and medical limitations for D6112?
D6112 has no specific age limitations, however patient candidacy relies on clinical considerations including bone density, general health status, and implant placement feasibility. Medical conditions that prevent implant surgery may restrict D6112 usage. Always coordinate with the patient's healthcare provider and thoroughly evaluate their medical history prior to treatment.
Is it possible to bill D6112 with other procedures on the same insurance claim?
Yes, D6112 may be billed together with related services like implant placement (D6010) or abutment placement (D6056), assuming these procedures are completed and thoroughly documented. Ensure proper CDT codes are used for each service and maintain comprehensive documentation demonstrating the medical necessity of all treatments provided.