Understanding Dental Code D6112

When to Use D6112 dental code

The D6112 dental code is designated for an implant/abutment supported removable denture for a partially edentulous maxillary arch. This CDT code is specific to cases where a patient is missing some, but not all, of their upper teeth (maxillary arch) and requires a removable prosthesis that is supported by implants or abutments. Use D6112 when the denture is designed to be removed by the patient and is anchored by dental implants, offering improved retention and function compared to traditional tissue-supported dentures.

It is important to distinguish D6112 from similar codes, such as D6114 (implant/abutment supported fixed denture for a completely edentulous arch) or D6110 (conventional removable denture for a completely edentulous arch), to ensure accurate coding and reimbursement.

Documentation and Clinical Scenarios

Proper documentation is essential for successful claims and compliance. For D6112, clinical notes should include:

• Diagnosis of partial edentulism in the maxillary arch
• Pre-operative radiographs and intraoral photos showing existing teeth and implant sites
• Details of the treatment plan, including the number and location of implants/abutments
• Type of removable prosthesis fabricated
• Materials used and retention mechanism (e.g., locator attachments, bars)
• Patient’s consent and understanding of removable nature

Common clinical scenarios include patients with failing upper teeth who retain some natural dentition and require improved stability and function beyond what a conventional partial denture can provide. D6112 is also appropriate when implants are strategically placed to support a removable prosthesis, especially in cases with compromised ridge anatomy.

Insurance Billing Tips

Billing for D6112 requires attention to detail. Here are actionable steps for maximizing reimbursement:

• Verify coverage: Before treatment, conduct thorough insurance verification to confirm benefits for implant-supported removable prostheses. Not all plans cover implant services, so obtain written predetermination when possible.
• Submit supporting documentation: Always include clinical notes, radiographs, and a narrative explaining the medical necessity for an implant-supported removable denture. Highlight why a conventional partial is insufficient.
• Use correct CDT codes: Pair D6112 with related procedure codes (e.g., implant placement, abutment connection) as appropriate, and ensure each code is supported by documentation.
• Monitor EOBs and AR: Review Explanation of Benefits (EOBs) promptly for denials or downgrades. If a claim is denied, follow up with a detailed appeal letter referencing the documentation and clinical rationale.

Successful dental offices standardize these workflows and train their teams to recognize the nuances of implant-supported prosthesis billing.

Example Case for D6112

Case: A 62-year-old patient presents with several missing upper teeth and remaining teeth with poor prognosis. After extractions, four implants are placed in the maxillary arch. A removable denture with locator attachments is fabricated, providing the patient with improved function and comfort.

Billing workflow:

• Verify the patient’s insurance coverage for implant-supported dentures and obtain predetermination.
• Document the patient’s partial edentulism, implant placement, and rationale for a removable prosthesis.
• Submit the claim using D6112, attaching all supporting documentation and a narrative.
• Review the EOB, and if necessary, submit an appeal with additional clinical justification.

This approach ensures accurate coding, maximizes reimbursement, and supports the patient’s clinical needs.