When is D8680 used?
The D8680 dental code applies to "orthodontic retention (removal of appliances, construction and placement of retainer(s))." Dental practices utilize D8680 when patients finish their active orthodontic care and the practitioner takes off fixed devices (like braces) and creates and provides retainers to preserve the corrected tooth positioning. This code does not cover routine retainer examinations or fixes—it specifically applies to the first-time removal and retainer delivery following treatment completion.
D8680 Charting and Clinical Use
Proper record-keeping is crucial for correct billing and claim processing. Patient records must clearly document:
Date when appliances were removed
Specifications of retainer(s) made and provided (such as upper, lower, retainer type)
Verification that patient finished active orthodontic care
Any applicable before-and-after photographs or dental models
Typical clinical situations for D8680 include:
Finishing conventional braces treatment with delivery of clear or Hawley retainers
Taking off aligner attachments and providing retention devices after clear aligner treatment
Billing and Insurance Considerations
When submitting D8680 claims, apply these recommended practices to improve claim approval and reduce rejections:
Check orthodontic coverage: Confirm with the insurance company whether retention services are covered and if they are part of the total orthodontic case or billed as separate services.
Include supporting records: Provide clinical documentation, treatment completion records, and photographs/models as proof of completed services.
Apply accurate coding: Avoid using D8680 for retainer fixes or routine retainer appointments.
Examine EOBs: Thoroughly review Explanation of Benefits for bundling rules or frequency restrictions. Some insurance plans may include D8680 in the overall orthodontic treatment fee.
File appeals when needed: If claims are rejected, submit comprehensive appeals with records demonstrating medical necessity and proper timing of the retention phase.
How dental practices use D8680
Case example: A 15-year-old patient finishes 24 months of full orthodontic care with fixed braces. During the debonding appointment, the orthodontist takes off the braces, makes impressions, and provides upper and lower clear retainers. The patient record includes the removal procedure, retainer delivery, and care instructions for retainer use. The practice submits D8680 for the appliance removal and retainer placement, including the final treatment report and photographs with the claim. The insurance company approves the claim as a covered service under the patient's orthodontic benefits.
This case demonstrates how complete documentation, proper code usage, and effective insurance coordination help ensure prompt payment for orthodontic retention procedures.
Common Questions
Can code D8680 be used for billing replacement retainers following the initial retention period?
D8680 is specifically designed for orthodontic appliance removal and the initial fabrication and delivery of retainers immediately after active treatment completion. For retainer replacements needed after the original retention phase, a different CDT code must be used, since D8680 does not include coverage for any retainers beyond the first set provided at treatment conclusion.
Does D8680 apply to retainers for both dental arches, or are separate billing codes needed?
Code D8680 encompasses the fabrication and delivery of retainer appliances, which can include retainers for both upper and lower arches when provided simultaneously. There is no requirement to use separate billing codes for each arch when both retainers are delivered together as part of the same post-treatment retention protocol.
What specific documentation is required when providing fixed versus removable retainers under code D8680?
When billing D8680, documentation must clearly identify the retainer type being provided. Fixed retainer records should include affected tooth numbers, bonding materials utilized, and attachment procedures performed. Removable retainer documentation should note impression or digital scan procedures, appliance specifications such as Hawley or Essix design, and patient care instructions provided. All cases require documentation of the appliance removal date and comprehensive patient education regarding retainer maintenance.