Understanding Dental Code D6060

When to Use D6060 dental code

The D6060 dental code is designated for an abutment-supported porcelain fused to metal (PFM) crown, predominantly base metal. This code is used when a dental implant abutment supports a PFM crown, and the crown’s metal substructure is made primarily of base metals (such as nickel-chromium or cobalt-chromium alloys). Use D6060 when restoring a single implant with a PFM crown, not for natural teeth or bridges. It’s essential to confirm that the abutment is in place and that the crown is being fabricated and delivered over an implant, not a natural tooth. For other types of crowns or abutment materials, refer to the appropriate CDT codes, such as D6058 for all-ceramic crowns or D6065 for high noble metal crowns.

Documentation and Clinical Scenarios

Proper documentation is critical for successful reimbursement. Always include the following in the patient’s record and insurance claim:

• Clinical notes detailing the need for the implant-supported crown (e.g., missing tooth, failed previous restoration).
• Radiographs showing the implant and abutment in place.
• Intraoral photographs of the implant site and restoration.
• Lab prescription specifying the use of a PFM crown with a base metal substructure.
• Date of implant placement and abutment connection.

Common scenarios for D6060 include single-tooth implant restorations in posterior or anterior regions where a PFM crown is chosen for its durability and cost-effectiveness.

Insurance Billing Tips

To maximize reimbursement and minimize claim denials for D6060:

• Verify coverage before treatment by obtaining a detailed breakdown of benefits and confirming implant crown coverage with the payer.
• Pre-authorize when possible. Submit a pre-treatment estimate with supporting documentation to anticipate coverage and patient responsibility.
• Use accurate narratives in the claim, specifying that the crown is abutment-supported and made of predominantly base metal.
• Attach all supporting documents (radiographs, photos, lab slips) to the claim. Missing documentation is a leading cause of denials.
• Track EOBs (Explanation of Benefits) and follow up promptly on any denials or requests for additional information.
• Appeal denied claims with additional documentation and a clear explanation of medical necessity, referencing the correct CDT code.

Staying organized and proactive in your billing workflow will improve your practice’s AR (Accounts Receivable) and reduce delays in payment.

Example Case for D6060

Scenario: A 52-year-old patient presents with a missing lower right first molar. An implant was placed three months ago, and the site has healed. The dentist selects a PFM crown with a base metal substructure for its strength and affordability. The abutment is placed, and the crown is fabricated and delivered.

Billing Steps:

1. Verify insurance coverage for implant crowns and confirm the patient’s eligibility.
2. Document clinical findings, take radiographs, and photograph the site.
3. Submit a pre-authorization with all supporting documents.
4. After approval, deliver the crown and submit the claim using D6060, attaching all required documentation.
5. Monitor the EOB and address any issues or denials promptly with an appeal if necessary.

This approach ensures accurate billing, minimizes delays, and supports optimal reimbursement for your dental practice.