When is D6119 used?
The D6119 dental code applies to an "implant/abutment supported interim fixed denture for edentulous arch – maxillary." This CDT code is utilized when delivering a temporary, fixed prosthetic device supported by implants or abutments for patients with complete tooth loss in the upper (maxillary) arch. The provisional denture serves to restore oral function and appearance during the healing or osseointegration period prior to placing the final prosthetic restoration. Apply D6119 exclusively when the prosthesis serves as an interim solution—indicating it is not the permanent, long-term restoration.
D6119 Charting and Clinical Use
Accurate documentation is crucial for effective billing and reimbursement success. Clinical records should clearly document:
The patient's complete tooth loss in the maxillary arch
The installation of implants or abutments
The clinical justification for delivering an interim (not permanent) fixed denture
The projected timeframe for placing the final prosthetic restoration
Typical clinical situations include:
Immediate installation following extractions and implant procedures, where a fixed provisional prosthesis is required for healing and patient well-being
Situations where soft tissue or bone augmentation necessitates a temporary phase before final prosthesis installation
Make sure to distinguish D6119 from codes for permanent prostheses, such as D6114 (implant/abutment supported fixed denture for edentulous arch – maxillary, definitive).
Billing and Insurance Considerations
Processing claims for D6119 demands careful attention to prevent denials and processing delays. Consider these practical approaches:
Pre-authorization: File a pre-treatment estimate including a comprehensive narrative describing the necessity for an interim prosthesis and the intended final restoration.
Include supporting materials: Provide clinical documentation, radiographic images, and photographs demonstrating the edentulous arch and implant installation.
Apply accurate CDT codes: Combine D6119 with relevant surgical and implant codes when appropriate, while avoiding duplicate charges for the same arch and treatment phase.
Monitor EOBs: Examine Explanation of Benefits statements thoroughly for partial reimbursements or rejections, and prepare to file claim appeals with supplementary documentation when necessary.
Manage benefits coordination: When patients have multiple coverage plans, confirm which plan serves as primary and file claims in proper sequence to prevent payment complications.
How dental practices use D6119
Case Study: A 65-year-old patient arrives with complete maxillary tooth loss. Four implants are installed, and an interim fixed denture is constructed to restore function and appearance throughout the 4-6 month osseointegration timeline. The practice submits D6119 for the interim prosthesis, including pre-treatment and post-treatment radiographs, a narrative outlining the treatment approach, and a schedule for the final prosthesis. When the insurance company requests supplementary documentation, the office responds quickly, achieving successful reimbursement for the interim treatment phase.
Through adherence to documentation and billing standards, dental practices can maintain proper coding accuracy and prompt payment processing for interim implant-supported prostheses using D6119.
Common Questions
Is D6119 applicable for patients with partial tooth loss in the upper jaw?
D6119 cannot be used for partial edentulism in the maxillary arch. This code is exclusively designated for patients who are completely edentulous in the upper jaw. When patients retain any natural teeth in the maxillary arch, alternative codes that properly represent the specific clinical circumstances and prosthetic treatment should be utilized.
What is the expected wearing duration for an interim fixed denture coded as D6119?
An interim fixed denture coded under D6119 serves as a temporary prosthetic solution during the healing phase or osseointegration period following implant placement. The wearing period generally spans from several weeks to multiple months, with the exact timeframe determined by individual healing rates and the comprehensive treatment plan for the permanent restoration.
Does the D6119 code encompass laboratory fabrication costs for the interim fixed denture?
Laboratory fabrication fees are typically excluded from the D6119 code and often require separate billing. It is essential to verify with the patient's insurance provider whether laboratory costs are covered under the primary code or if they must be listed as distinct charges on the insurance claim.