Understanding Dental Code D6119

When to Use D6119 dental code

The D6119 dental code is designated for an "implant/abutment supported interim fixed denture for edentulous arch – maxillary." This CDT code is used when providing a temporary, fixed prosthesis supported by implants or abutments for patients who are completely edentulous in the upper (maxillary) arch. The interim denture is intended to restore function and aesthetics during the healing or osseointegration phase before the final prosthesis is delivered. Use D6119 only when the prosthesis is truly interim—meaning it is not the definitive, long-term restoration.

Documentation and Clinical Scenarios

Proper documentation is essential for successful billing and reimbursement. Clinical notes should clearly state:

• The patient’s edentulous status in the maxillary arch
• The placement of implants or abutments
• The rationale for providing an interim (not final) fixed denture
• The expected timeline for delivery of the definitive prosthesis

Common clinical scenarios include:

• Immediate placement after extractions and implant surgery, where a fixed interim prosthesis is needed for healing and patient comfort
• Cases where soft tissue or bone grafting requires a provisional phase before final prosthesis placement

Be sure to differentiate D6119 from codes for definitive prostheses, such as D6114 (implant/abutment supported fixed denture for edentulous arch – maxillary, definitive).

Insurance Billing Tips

Billing for D6119 requires attention to detail to minimize denials and delays. Here are actionable steps:

• Pre-authorization: Submit a pre-treatment estimate with a detailed narrative explaining the need for an interim prosthesis and the planned final restoration.
• Attach supporting documentation: Include clinical notes, radiographs, and photos showing the edentulous arch and implant placement.
• Use correct CDT codes: Pair D6119 with related surgical and implant codes as appropriate, but avoid duplicate billing for the same arch and phase of treatment.
• Track EOBs: Review Explanation of Benefits (EOBs) carefully for partial payments or denials, and be prepared to submit claim appeals with additional documentation if needed.
• Coordinate benefits: If the patient has dual coverage, verify which plan is primary and submit claims accordingly to avoid payment delays.

Example Case for D6119

Case Study: A 65-year-old patient presents with a fully edentulous maxillary arch. Four implants are placed, and an interim fixed denture is fabricated to restore function and aesthetics during the 4-6 month osseointegration period. The office bills D6119 for the interim prosthesis, attaching pre-op and post-op radiographs, a narrative detailing the treatment plan, and a timeline for the final prosthesis. The insurance carrier requests additional documentation, which the office promptly provides, resulting in successful reimbursement for the interim phase.

By following best practices in documentation and billing, dental teams can ensure accurate coding and timely payment for interim implant-supported prostheses using D6119.