Understanding Dental Code D6070

When to Use D6070 dental code

The D6070 dental code is designated for an abutment supported retainer for a porcelain fused to metal fixed partial denture (FPD), where the metal is predominantly base metal. This CDT code is specifically used when a patient requires a bridge (FPD) and the retainer (crown portion) is supported by an implant abutment, not a natural tooth. The prosthesis must be porcelain fused to a base metal alloy, which is a common, cost-effective option in restorative dentistry. Use D6070 when the abutment and retainer are placed at the same appointment, and the material and support type match the code description.

Documentation and Clinical Scenarios

Accurate documentation is essential for successful reimbursement and compliance. For D6070, ensure the following are included in the patient record:

• Detailed clinical notes describing the edentulous space, implant placement, and rationale for an abutment-supported FPD.
• Radiographs or CBCT scans confirming implant position and integration.
• Material specifications indicating the use of porcelain fused to predominantly base metal alloy.
• Lab invoices or work orders supporting the type of prosthesis fabricated.

Common clinical scenarios include patients missing one or more teeth with stable implants in place and requiring a bridge for functional and esthetic restoration. If a different material is used, such as high noble metal or all-ceramic, reference the appropriate CDT code, such as D6067 for abutment supported retainer for porcelain fused to high noble metal FPD.

Insurance Billing Tips

Billing for D6070 requires attention to detail to avoid denials and delays. Follow these best practices:

• Verify insurance benefits before treatment, confirming implant and prosthetic coverage, frequency limitations, and waiting periods.
• Submit pre-authorizations with supporting documentation, including clinical notes, radiographs, and treatment plans.
• Use precise CDT code language on claims and attach narratives if the clinical situation is complex or if the patient has a history of prior prosthetics.
• Track EOBs (Explanation of Benefits) closely and be prepared to file claim appeals with additional documentation if reimbursement is denied or reduced.
• Coordinate benefits if the patient has dual coverage, and ensure correct sequencing of primary and secondary claims.

Timely and thorough documentation, paired with proactive communication with payers, helps maximize reimbursement and minimize AR (accounts receivable) days.

Example Case for D6070

Case: A 58-year-old patient presents with a missing mandibular first molar. An implant was placed and has successfully osseointegrated. The treatment plan calls for a three-unit FPD with the middle pontic replacing the missing tooth, and the retainer is supported by the implant abutment. The prosthesis is fabricated as porcelain fused to a base metal alloy, meeting the requirements for D6070.

Billing Steps:

1. Document clinical findings, implant integration, and material choice in the patient chart.
2. Obtain and attach pre- and post-op radiographs to the claim.
3. Submit the claim with D6070, including a narrative describing the clinical need and prosthesis type.
4. Follow up with the insurance carrier, review the EOB, and address any requests for additional information promptly.

This approach ensures compliance, supports medical necessity, and streamlines reimbursement for the dental office.