When is D6118 used?
The D6118 dental code applies to implant/abutment supported temporary fixed dentures for edentulous mandibular (lower) arches. This code is utilized when patients need a provisional fixed prosthetic device supported by implants or abutments while tissues heal or integrate before receiving their final denture. D6118 specifically covers temporary restorations, not permanent ones, offering functionality and appearance while patients wait for their definitive prosthetic solution.
D6118 Charting and Clinical Use
Accurate documentation is crucial for proper billing and claim acceptance. Clinical records must clearly document:
Patient has complete tooth loss in the mandibular arch.
Implants or abutments are placed and supporting the temporary prosthesis.
The provisional nature of the prosthetic device (not the final restoration).
Medical necessity for the interim fixed denture (such as healing period, osseointegration, patient comfort).
Typical clinical situations involve complete arch implant procedures where immediate loading is preferred, or when the patient's permanent prosthesis cannot be created until after healing or additional procedures. Documentation should always include before and after radiographs, implant placement documentation, and an approved treatment plan in the patient file.
Billing and Insurance Considerations
Processing claims for D6118 demands careful attention to prevent rejections or payment delays. Consider these recommendations:
Check coverage: Prior to treatment, confirm whether the patient's insurance covers temporary implant-supported prosthetics, as coverage varies among plans.
Provide comprehensive narratives: Include thorough explanations of medical necessity for temporary prosthetics, citing healing requirements, patient circumstances, and treatment progression.
Include supporting materials: Submit clinical documentation, radiographs, and treatment plans with claims to justify D6118 usage and speed processing.
Manage multiple coverage: For patients with multiple insurance plans, ensure proper coordination to optimize reimbursement and reduce patient expenses.
Handle claim rejections: When claims are denied, examine the explanation of benefits for reasons, collect missing documentation, and file comprehensive appeals referencing CDT definitions and clinical necessity.
Note that D6118 differs from permanent prosthetic codes like D6114 (permanent implant/abutment supported fixed denture for edentulous mandibular arch). Proper code selection prevents billing errors.
How dental practices use D6118
A patient presents with complete lower arch tooth loss and receives four implants to support a fixed prosthetic device. Because osseointegration requires a healing period, the dentist creates and places a temporary fixed denture, enabling the patient to maintain function and appearance during recovery. Clinical records document the temporary nature of the prosthesis, implant quantity and positioning, and expected timeline for permanent restoration. The practice files a claim using D6118, includes all supporting materials, and provides comprehensive narrative documentation. Insurance approves the claim, and following healing completion, the patient receives their permanent prosthesis, billed under the corresponding permanent procedure code.
Following these guidelines and properly applying D6118 helps dental practices achieve accurate billing, prompt payment, and excellent patient care throughout complex implant procedures.
Common Questions
Do all dental insurance plans provide coverage for D6118?
Coverage for D6118 is not universal across all dental insurance plans. Insurance coverage for interim implant-supported fixed dentures differs significantly between providers and individual plan types. Prior to beginning treatment, it's crucial to conduct a thorough benefit verification with the patient's insurance carrier to confirm whether D6118 is included as a covered benefit and to understand any applicable frequency limitations or replacement restrictions.
Is D6118 applicable for upper jaw treatments?
D6118 cannot be used for maxillary (upper) arch treatments. This code is exclusively designated for interim fixed dentures in the edentulous mandibular (lower) arch. When treating the maxillary (upper) arch, practitioners should utilize the appropriate alternative code, such as D6117, which is specifically designed for interim prosthetic treatments in the upper jaw.
How do interim and final fixed dentures differ in coding and billing procedures?
Interim fixed dentures (D6118) represent temporary prosthetic solutions implemented during the healing or transitional period following implant placement and are not considered the patient's permanent restoration. Final fixed dentures serve as the definitive prosthetic solution and require separate coding (such as D6114 for mandibular arch treatments). Each prosthetic phase requires independent documentation and billing with precise service dates and comprehensive supporting clinical documentation to ensure proper reimbursement and treatment tracking.