When is D6793 used?
The D6793 dental code represents a temporary retainer crown that serves as part of a fixed partial denture (bridge) during the waiting period before the final restoration is completed. This code applies when patients need a temporary solution to preserve function, appearance, and tissue health while awaiting the creation of the permanent retainer crown. D6793 should only be reported when the temporary retainer is required for a prolonged duration, not for standard, brief temporization procedures.
D6793 Charting and Clinical Use
Accurate documentation is essential for successful payment when submitting D6793 claims. Dental practices should clearly record the clinical justification for the temporary retainer crown, including complex restoration cases, delayed laboratory work, or the need to assess tissue healing before final placement. Clinical records should contain:
The justification for the temporary retainer (such as major pre-prosthetic procedures, individual patient healing requirements, or complicated bite adjustments).
The expected length of temporary placement.
Photographs or X-rays, when available, to demonstrate clinical necessity.
Information about the materials and methods used for the temporary crown.
Typical situations include complete mouth reconstructions, cases requiring significant tissue care, or when the final restoration is postponed due to insurance approval processes or laboratory processing delays.
Billing and Insurance Considerations
To improve payment rates and reduce claim rejections for D6793, implement these recommended practices:
Confirm benefits: Review the patient's dental insurance for temporary crown coverage, since some policies may not cover or may restrict payment for provisional restorations.
Include supporting materials: Always attach clinical documentation, photographs, and a written explanation detailing why an extended temporary retainer is necessary.
Apply proper CDT codes: Make sure D6793 is not mixed up with codes for standard temporary crowns or other provisional devices. For instance, when billing for a temporary pontic, use the correct code like D6253 for a temporary pontic.
Challenge rejections: When an Explanation of Benefits (EOB) rejects the claim, examine the denial reason, add more supporting evidence, and file a claim appeal when appropriate.
Prompt and precise claim submission, combined with effective insurance company communication, supports better accounts receivable (AR) oversight.
How dental practices use D6793
Practice Example: A 58-year-old patient requires a three-unit bridge to restore a missing first molar. Following recent bone grafting and soft tissue enhancement, the dentist decides that a temporary retainer crown is needed for three months to ensure proper healing before placing the final bridge. The dental staff records the surgical background, reasoning for the provisional restoration, and projected timeframe. During billing, they submit D6793 with a comprehensive explanation and supporting clinical images. The insurance company initially asks for additional information, but following a quick response with extra documentation, the claim receives approval and payment.
This case demonstrates the value of complete documentation, effective communication, and determination in dental billing for temporary retainer crowns.
Common Questions
Do all dental insurance plans cover D6793?
Coverage for D6793 varies significantly among dental insurance plans. Many insurers do not reimburse for this code, as they may bundle provisional retainer crowns with final restorations or classify them as non-covered services. To prevent unexpected claim denials, it's essential to verify patient benefits and secure pre-authorization whenever possible before proceeding with treatment.
What is the typical duration for wearing a provisional retainer crown (D6793)?
Provisional retainer crowns are designed as temporary restorations and are generally worn for several weeks to a few months. The exact timeframe depends on factors such as patient healing requirements, laboratory processing times, and the comprehensive treatment plan. If the provisional crown needs to remain in place longer than usual, proper documentation and clinical justification should be recorded in the patient's file.
Is it appropriate to bill D6793 alongside other crown procedure codes?
D6793 cannot be billed simultaneously with other provisional or permanent crown codes for the same tooth on the same service date. However, it may be appropriately billed as part of a phased treatment approach where the provisional retainer crown serves as an interim step before placing the final restoration. Ensure that all coding accurately represents the services delivered and maintain thorough documentation to support your claims.