Understanding Dental Code D6074

When to Use D6074 dental code

The D6074 dental code is designated for an abutment-supported retainer for a cast metal fixed partial denture (FPD) using noble metal. This CDT code is used when a patient requires a bridge (FPD) and the retainer (the part that anchors the bridge to an abutment tooth or implant) is fabricated from a noble metal alloy. Noble metals include gold, palladium, platinum, and alloys containing a high percentage of these metals. Use D6074 when the clinical situation calls for a durable, biocompatible retainer and the treatment plan specifies a cast metal FPD supported by an abutment.

Documentation and Clinical Scenarios

Accurate documentation is essential for successful billing and claim approval. When using D6074, ensure your clinical notes include:

• Detailed diagnosis and rationale for the FPD, including missing tooth/teeth and abutment selection.
• Material specifications, confirming the use of a noble metal alloy for the retainer.
• Pre-operative and post-operative radiographs showing the abutment teeth and the area to be restored.
• Periodontal and restorative charting to support the necessity of the FPD and abutment selection.

Common clinical scenarios include replacing a single missing tooth with a three-unit bridge, where the abutment teeth are healthy and suitable for a noble metal retainer. Always document why a noble metal was chosen over base or high noble options, as this can affect insurance reimbursement.

Insurance Billing Tips

Maximize reimbursement for D6074 by following these best practices:

• Verify benefits: Before treatment, confirm the patient’s coverage for FPDs and noble metal materials. Many plans have specific limitations or downgrades for metal types.
• Pre-authorization: Submit a pre-treatment estimate with supporting documentation (radiographs, charting, narrative) to reduce claim denials.
• Use correct CDT codes: Pair D6074 with related codes for the pontic and other retainers as appropriate. For example, if using a porcelain-fused-to-metal pontic, reference the appropriate code with a descriptive anchor tag, such as porcelain fused to noble metal pontic.
• Appeal denials: If a claim is denied due to material downgrades or missing documentation, submit a detailed appeal with clinical justification and supporting evidence.
• Track AR: Monitor accounts receivable for outstanding claims and follow up promptly to ensure timely payment.

Example Case for D6074

Consider a 55-year-old patient missing tooth #19, with teeth #18 and #20 serving as abutments. After clinical evaluation, the dentist recommends a three-unit FPD with cast metal retainers on both abutments using a noble metal alloy, due to the patient’s history of metal allergies and the need for strength. The office submits a pre-authorization with radiographs, periodontal charting, and a narrative explaining the material choice. The claim is processed and paid according to the plan’s schedule for D6074, with the EOB reflecting the noble metal allowance. This case highlights the importance of thorough documentation and proactive insurance communication for successful billing.