Understanding Dental Code D6067

When to Use D6067 dental code

The D6067 dental code is designated for an implant-supported metal-ceramic crown, specifically when the crown is placed on an implant abutment. This code should be used when a patient requires a single crown restoration that is supported by a dental implant, not a natural tooth. It is important to distinguish D6067 from other implant crown codes, such as D6065 (implant-supported porcelain/ceramic crown), to ensure accurate billing and avoid claim denials.

Documentation and Clinical Scenarios

Proper documentation is essential when billing for D6067. Clinical notes should clearly indicate:

• The presence and location of the dental implant
• The type of crown material used (metal-ceramic)
• The abutment connection
• Pre- and post-operative radiographs
• Detailed narrative describing the clinical need for an implant-supported crown

Common clinical scenarios include patients with a single missing tooth in the posterior or anterior region where a metal-ceramic crown is the preferred restorative option due to its strength and esthetics. Always ensure the clinical rationale is well-documented to support the use of D6067 during insurance review or audits.

Insurance Billing Tips

To maximize reimbursement and minimize delays, follow these best practices when billing D6067:

• Verify patient benefits: Confirm implant and crown coverage with the payer before treatment. Many plans have specific exclusions or waiting periods for implants.
• Submit supporting documentation: Include clinical notes, radiographs, and a detailed narrative with your claim. This helps justify medical necessity and reduces the risk of denial.
• Use correct CDT codes: Double-check that D6067 is appropriate for the material and restoration type. If a different material is used, select the corresponding code.
• Track EOBs and AR: Monitor Explanation of Benefits (EOBs) and accounts receivable (AR) to promptly address underpayments or denials. If a claim is denied, review the payer’s reason and submit a timely appeal with additional documentation.

Successful dental offices often use a checklist to ensure all required documentation is included before claim submission, reducing rework and improving cash flow.

Example Case for D6067

Patient: John Doe, missing tooth #19, healthy adjacent teeth.
Treatment: Placement of a titanium dental implant, followed by a custom abutment and a metal-ceramic crown.
Billing: After verifying coverage, the office submits a claim using D6067 for the crown, along with pre- and post-op radiographs and a narrative explaining the clinical need. The claim is processed without delay, and payment is received as expected.

This example highlights the importance of accurate code selection, thorough documentation, and proactive insurance communication when billing for implant-supported crowns using D6067.