When is D6720 used?
The D6720 dental code is applied when billing for a retainer crown made from high noble metal that serves as part of a fixed partial denture system. This code specifically covers the anchor crown component of a bridge restoration, where the high noble metal crown acts as a supporting structure for the prosthetic appliance. D6720 is the correct choice when treating patients who need a fixed bridge restoration and the supporting tooth requires a full cast high noble metal crown for proper retention. Using this code appropriately helps ensure correct billing practices and proper compensation for the specialized materials and clinical work required in these restorative procedures.
D6720 Charting and Clinical Use
Proper record-keeping is crucial when submitting claims for D6720. Dental practices should maintain:
Comprehensive clinical records explaining why a fixed partial denture is necessary and why high noble metal was selected for the retainer crown.
Pre-treatment X-rays demonstrating the abutment tooth's health and appropriateness for crown placement.
Clinical photographs when possible to document the treatment rationale.
Material documentation confirming the use of high noble metal alloys.
Typical situations for D6720 involve restoring missing teeth with bridge work when neighboring teeth are structurally sound enough to function as abutments and need full crown coverage for support. When alternative materials are selected (like base metal alloys or ceramic-metal combinations), practitioners should reference the corresponding CDT codes, such as D6750 for ceramic fused to high noble metal retainer crowns.
Billing and Insurance Considerations
To optimize payment and reduce claim rejections for D6720, implement these strategies:
Coverage Verification: Check patient benefits for fixed partial denture coverage and high noble metal crown allowances prior to treatment. Review any frequency restrictions, waiting periods, and replacement timeframes.
Prior Authorization: File pre-treatment estimates with supporting materials (X-rays, treatment notes, and material specifications) to confirm medical necessity and prevent unexpected costs.
Claims Processing: Accurately report D6720 on insurance forms, include all supporting materials, and specify the exact tooth number and position of the retainer crown.
Payment Review: Examine explanation of benefits statements for correct payment amounts and watch for downgrades or alternative benefit applications. When payments are insufficient or denied, prepare appeals with additional supporting evidence.
Maintaining clear communication with insurance companies and patients supports healthy cash flow and strengthens the practice's financial management processes.
How dental practices use D6720
Clinical Example: A patient arrives with a missing mandibular first molar (#19). The neighboring teeth (#18 and #20) are in good condition but need full coverage to anchor a fixed bridge. Following consultation, the dentist suggests a three-unit bridge featuring a high noble metal retainer crown on #18 (D6720), a pontic replacing #19, and a retainer crown on #20. The treatment approach, radiographic images, and material selection are properly recorded. The billing team confirms insurance benefits, files for pre-approval, and obtains authorization. After treatment completion, the claim is processed with complete documentation, leading to prompt payment without complications.
This example demonstrates how accurate coding, complete documentation, and careful insurance management work together for successful D6720 billing.
Common Questions
Which materials meet the 'high noble metal' criteria for D6720 billing?
High noble metal alloys must contain a minimum of 60% noble metals (including gold, platinum, and palladium), with gold comprising at least 40% of the total composition. For proper D6720 billing, verify that your laboratory documentation or invoice clearly states the alloy composition to satisfy insurance verification requirements.
Is D6720 appropriate for coding implant-supported bridge work?
D6720 cannot be used for implant-supported bridges. This code applies exclusively to retainer crowns placed on natural tooth abutments as components of fixed partial dentures. For implant-supported restorations, use the appropriate implant codes such as D6065 or D6078, based on the specific restoration being provided.
What is the proper coding approach for replacing a retainer crown on an existing bridge?
When replacing a retainer crown that is part of an existing bridge, D6720 remains the correct code if the replacement crown is porcelain fused to high noble metal and functions as a bridge retainer. Be sure to document the clinical reason for replacement (such as caries or crown fracture) and submit supporting clinical photographs and detailed narratives with your insurance claim.