Understanding Dental Code D6090

When to Use D6090 dental code

The D6090 dental code is designated for the repair of implant-supported prostheses, and is reported when a prosthesis that is supported by dental implants requires repair due to mechanical failure, wear, or accidental damage. This code is not for routine maintenance or adjustments, but specifically for repairs that restore the prosthesis to proper function. Common scenarios include fractured porcelain, broken framework, or damaged attachment components. Use D6090 when the repair is more extensive than a simple adjustment, but does not require a complete remake of the prosthesis.

Documentation and Clinical Scenarios

Accurate documentation is critical when billing with D6090. The clinical notes should clearly describe the nature of the damage, the type of prosthesis involved (fixed or removable), and the specific repairs performed. Include pre- and post-repair photographs, radiographs if relevant, and a detailed narrative explaining why the repair was necessary. For example, if a patient presents with a fractured porcelain on an implant-supported bridge, document the location, extent of the fracture, and the repair materials used. Always specify the original placement date and type of prosthesis to support the claim, and retain all supporting documentation in the patient’s chart for potential insurance audits.

Insurance Billing Tips

When submitting claims for D6090, attach a comprehensive narrative and supporting images to justify the necessity of the repair. Many payers require a detailed explanation, especially if the prosthesis is relatively new. Verify the patient’s insurance coverage for implant-related services prior to treatment, as not all plans cover repairs to implant-supported prostheses. If the claim is denied, review the Explanation of Benefits (EOB) for the denial reason and be prepared to submit a claim appeal with additional documentation. For recurring repairs or complex cases, consider referencing related codes such as maintenance procedures for implant prostheses or unspecified implant procedures to clarify the scope of work.

Example Case for D6090

A patient returns to your office with a fractured acrylic on a lower implant-supported overdenture placed two years ago. After clinical evaluation, you determine that the overdenture needs reinforcement and replacement of the fractured section. You document the findings, take photographs, and note the original prosthesis delivery date. The repair is performed in-house, restoring the overdenture’s function and fit. For billing, you submit D6090 with a detailed narrative, before-and-after photos, and a copy of the original prosthesis invoice. The insurance payer requests additional information, so you respond promptly with clinical notes and radiographs, resulting in successful claim reimbursement.