When is D6740 used?
The D6740 dental code applies to a retainer crown that functions as part of a fixed partial denture (FPD), also called a bridge. This code should be utilized when a crown acts as an anchor to support a pontic (replacement tooth) in a bridge structure, not as an individual restoration. It's essential to differentiate D6740 from codes used for individual crowns or other bridge elements to ensure proper billing and prevent claim rejections. Apply D6740 when the treatment involves replacing missing teeth with a bridge, and the crown is created to secure the prosthetic to neighboring natural teeth or implants.
D6740 Charting and Clinical Use
Accurate documentation is essential for successful payment when submitting D6740. The treatment records should clearly document:
The existence of missing teeth requiring a fixed bridge restoration.
The teeth serving as anchors and their health status (e.g., sound, periodontally secure).
X-rays or clinical photographs displaying the gap and anchor teeth.
The construction and material of the retainer crown (e.g., ceramic, porcelain-fused-to-metal).
Typical treatment situations include:
Restoring one missing tooth using a three-unit bridge, where D6740 applies to each anchor crown.
Treating multiple missing teeth with an extended FPD, using D6740 for each retainer crown supporting the bridge.
Billing and Insurance Considerations
To optimize payment and reduce processing delays, implement these recommended practices when submitting D6740:
Prior approval: Send a treatment plan with supporting materials (X-rays, periodontal records, treatment notes) to verify benefits before beginning care.
Proper coding: Apply D6740 exclusively for retainer crowns within a bridge. For individual crowns, select the correct crown code such as porcelain fused to metal crown.
Complete narratives: Provide a clear narrative describing the bridge necessity, anchor teeth used, and rationale for the retainer crown.
Benefits coordination: For patients with multiple insurance plans, confirm primary and secondary coverage and process claims properly to prevent payment issues.
Claim appeals: When claims are rejected, examine the explanation of benefits for rejection reasons, collect additional documentation, and file a prompt appeal with comprehensive explanation and supporting materials.
How dental practices use D6740
Practice Example: A patient arrives with a missing upper right first molar (#3). The neighboring teeth (#2 and #4) are healthy and appropriate for anchor use. The treatment approach includes a three-unit bridge, featuring retainer crowns on #2 and #4 with a pontic replacing #3. For claim submission, D6740 applies to both #2 and #4, while the pontic uses the corresponding pontic code. The treatment documentation contains initial X-rays, a narrative explaining the bridge plan, and verification of anchor tooth stability. The claim submission includes all necessary documentation, leading to quick approval and reimbursement.
Common Questions
Why do insurance companies frequently deny D6740 claims?
Insurance companies commonly deny D6740 claims due to inadequate documentation (missing X-rays or clinical narratives), improper code usage (applying D6740 to single crowns or implant crowns rather than bridge retainers), failure to obtain pre-authorization when required, or patients not fulfilling plan criteria such as waiting periods or frequency restrictions. Comprehensive documentation and proper benefit verification can prevent these denials.
Does D6740 apply to crowns on both front and back teeth?
Yes, D6740 applies to crowns on both anterior and posterior teeth, provided the crown serves as a retainer for a fixed partial denture (bridge). The code's applicability depends on the crown's function as part of a bridge assembly rather than its location in the mouth.
Do I need to indicate the crown material when submitting D6740 claims?
Certain insurance carriers require specification of the crown material (porcelain/ceramic, metal, or porcelain fused to metal) when submitting D6740 claims. It's essential to verify each payer's specific requirements and include material information when requested, as this may influence coverage decisions or reimbursement amounts.