Understanding Dental Code D6064

When to Use D6064 dental code

The D6064 dental code is used to report an abutment-supported cast metal crown (noble metal) in dental billing. This CDT code applies when a patient receives a crown made primarily of noble metal alloys, such as gold, palladium, or platinum, placed on an implant abutment. It is essential to distinguish D6064 from other implant crown codes, such as D6065 (porcelain/ceramic crown) or D6062 (high noble metal), to ensure accurate billing and reimbursement. Use D6064 only when the crown is fabricated from noble (not high noble or base) metal and is supported by an implant abutment, not a natural tooth.

Documentation and Clinical Scenarios

Proper documentation is crucial for successful claims using D6064. Ensure the patient’s chart clearly indicates:

• The presence of a dental implant and abutment at the treatment site
• The material used for the crown (noble metal, with specific alloy details)
• Pre- and post-operative radiographs showing the implant and abutment
• Clinical notes describing the need for a cast metal crown (e.g., occlusal forces, patient preference, or allergy to other materials)

Common clinical scenarios for D6064 include restoring posterior implants where strength and durability are prioritized, or when a patient specifically requests a noble metal restoration due to biocompatibility concerns.

Insurance Billing Tips

To maximize reimbursement and minimize denials for D6064, follow these best practices:

• Verify benefits: Before treatment, confirm the patient's implant and crown coverage, annual maximums, and frequency limitations with their insurer.
• Pre-authorization: Submit a detailed pre-treatment estimate with supporting documentation, including radiographs and narrative, to obtain written approval.
• Claim submission: Use the correct CDT code (D6064) and include all required attachments—radiographs, clinical notes, and lab invoices specifying noble metal content.
• Follow up: Monitor claim status, review EOBs for accuracy, and be prepared to submit appeals with additional documentation if the claim is denied or downgraded.

Successful dental offices maintain a checklist for implant crown claims and train their billing team on the nuances of CDT codes to avoid common errors, such as miscoding the crown material or failing to distinguish between abutment-supported and tooth-supported restorations.

Example Case for D6064

Consider a patient missing a lower first molar, restored with a dental implant and a custom abutment. The dentist recommends a cast noble metal crown due to the patient’s history of bruxism and preference for a durable, biocompatible material. The office verifies implant crown coverage, submits a pre-authorization with radiographs and a narrative, and receives approval. After delivering the crown, the billing team submits a claim using D6064, attaches the lab invoice specifying the noble metal alloy, and follows up until payment is received. This step-by-step approach ensures accurate reimbursement and a smooth patient experience.