Understanding Dental Code D6102

When to Use D6102 dental code

The D6102 dental code is specifically designated for the debridement and osseous contouring of a peri-implant defect or defects surrounding a single dental implant. This procedure also includes the surface cleaning of exposed implant surfaces, as well as flap entry and closure. Dental teams should use D6102 when treating peri-implantitis or other peri-implant defects that require surgical intervention beyond routine maintenance or simple cleaning. It is not appropriate for routine implant maintenance (see D6080) or for procedures involving multiple implants at the same site.

Documentation and Clinical Scenarios

Accurate documentation is critical when billing D6102. Clinical notes should clearly describe the presence and extent of peri-implant defects, the need for surgical debridement, and the steps taken during the procedure. Include pre-operative radiographs, periodontal charting, and intraoperative photos when possible. Common clinical scenarios include:

• Patients presenting with peri-implantitis and bone loss around a single implant
• Cases where non-surgical therapy has failed and surgical intervention is indicated
• Exposed implant threads with associated inflammation and bone loss

Be sure to document the patient’s symptoms, clinical findings, and the rationale for choosing surgical debridement and osseous contouring.

Insurance Billing Tips

When submitting claims for D6102, follow these best practices to improve claim acceptance and minimize denials:

• Pre-authorization: Always check with the patient’s insurance for coverage and pre-authorization requirements, as many plans consider this a medical necessity procedure.
• Detailed narratives: Attach a clear, concise narrative explaining the diagnosis (e.g., peri-implantitis), previous treatments attempted, and the clinical justification for surgical intervention.
• Supporting documentation: Include radiographs, periodontal charting, and intraoral photographs to substantiate the claim.
• Coordination of benefits: If the patient has dual coverage, coordinate benefits to maximize reimbursement and reduce patient out-of-pocket costs.
• Appeals process: If the claim is denied, review the Explanation of Benefits (EOB), address the denial reason, and submit a timely appeal with additional documentation if needed.

Example Case for D6102

Case Example: A 62-year-old patient presents with bleeding, swelling, and radiographic evidence of bone loss around a single mandibular implant. Non-surgical therapy with local antimicrobials was attempted without resolution. The periodontist documents a 6mm peri-implant pocket and exposed threads. Surgical debridement and osseous contouring are performed under local anesthesia, with thorough cleaning of the implant surface, flap entry, and closure. The procedure and clinical findings are documented in detail, with pre- and post-operative images attached to the insurance claim. The claim is submitted with a narrative and supporting documentation, resulting in successful reimbursement under D6102.

By understanding the correct use, documentation, and billing strategies for D6102, dental practices can ensure accurate reimbursement and optimal patient care outcomes.