When is D6607 used?
The D6607 dental code applies to retainer inlays, which are restorative elements utilized in fixed partial dentures (bridges). This code is applied when a cast metal inlay is created to function as a bridge retainer, securing the prosthetic device to an abutment tooth. Dental offices should choose D6607 when the treatment plan calls for a cast inlay retainer (rather than a complete crown or onlay) as part of a fixed bridge, and the restoration qualifies as a retainer instead of an independent inlay.
D6607 Charting and Clinical Use
Proper documentation is crucial for effective claim processing and payment. When applying D6607, make sure your clinical records clearly outline:
The abutment tooth receiving treatment and its current state
The rationale for choosing a cast inlay retainer over alternative retainer options
Specifications of the fixed partial denture (such as length, absent tooth/teeth, anchor teeth)
Before and after treatment radiographs
Materials utilized and treatment procedures
Typical clinical situations for D6607 involve patients with a missing tooth where the neighboring tooth remains structurally intact but doesn't need complete crown coverage. In these cases, a conservative cast inlay serves to retain the bridge while maintaining more original tooth material.
Billing and Insurance Considerations
Correct billing of D6607 demands careful attention and a systematic approach to insurance processes:
Pre-authorization: File a pre-authorization with supporting materials, including diagnostic imaging and an explanation detailing why a cast inlay retainer is necessary.
Claim processing: Apply the D6607 code on your billing form, making sure all fields (tooth identification, surfaces, and prosthetic information) are properly filled out.
Benefits coordination: When patients have multiple insurance plans, determine the primary carrier and file claims in the correct sequence to prevent payment complications.
Appeals process: If claims are rejected, examine the Explanation of Benefits for rejection causes. File a comprehensive appeal including additional evidence like clinical photographs, X-rays, and a medical necessity letter.
Claim tracking: Monitor claims through your billing system and contact insurers if responses exceed normal processing periods.
How dental practices use D6607
Take a patient who is missing tooth #19, while teeth #18 and #20 remain present and healthy. Tooth #18 contains a minor existing filling but is otherwise sound. The practitioner chooses to place a fixed partial denture (bridge) using a cast inlay retainer on #18 (D6607) and a complete coverage retainer on #20 (porcelain fused to metal crown retainer). The treatment records contain initial radiographs, mouth photos, and documentation explaining the conservative treatment choice. The insurance submission includes D6607 for #18, D6750 for #20, and the correct pontic code for #19. Following pre-authorization, the claim receives approval and payment processes smoothly due to complete documentation and accurate coding.
Common Questions
What distinguishes noble metals from high noble metals in dental restorative procedures?
In dental applications, noble metals encompass gold, palladium, and platinum alloys known for their excellent resistance to corrosion and oxidation. High noble metals contain a greater concentration of these precious metals, requiring at least 60% noble metal content with a minimum of 40% gold. It's important to note that D6607 is designated for cast noble metal alloys, while high noble metal alloys are classified under a different CDT code (D6605).
Is D6607 applicable for restorations on both front and back teeth?
D6607 can indeed be utilized for restorations on both anterior and posterior teeth, provided the clinical circumstances justify the use of a cast noble metal retainer inlay as a component of a fixed partial denture. The selection depends on factors such as remaining tooth structure, aesthetic requirements, and the dentist's professional assessment of the case.
What patient conditions might preclude the use of a retainer inlay under D6607?
Retainer inlays coded under D6607 are most appropriate for patients with healthy abutment teeth that possess adequate structure to support an inlay restoration. This treatment is contraindicated in cases involving extensive dental caries, inadequate enamel structure, or compromised periodontal health, where full-coverage retainers or alternative therapeutic approaches would be more suitable.