Understanding Dental Code D6195

When to Use D6195 dental code

The D6195 dental code is designated for an abutment supported retainer used in implant-supported fixed partial dentures. This CDT code specifically applies when a retainer (such as a crown or bridge unit) is placed on an abutment that is attached to a dental implant, serving as a support for a fixed prosthesis. Dental teams should select D6195 when the restoration is not directly on the implant body, but rather on an abutment that connects to the implant. Using this code correctly ensures accurate reporting and reimbursement for complex implant cases.

Documentation and Clinical Scenarios

Accurate documentation is essential for successful billing of D6195. Clinical notes should clearly describe:

• The presence and location of the dental implant(s)
• The type of abutment used (custom or prefabricated)
• The nature of the retainer (e.g., crown, bridge unit) and its relationship to the abutment
• Radiographs or intraoral photos showing the abutment and prosthesis in place
• Detailed treatment narrative explaining why an abutment-supported retainer was necessary

Common clinical scenarios include replacing multiple missing teeth with an implant-supported bridge, where one or more retainers are placed on abutments attached to implants. If a retainer is placed directly on the implant without an abutment, consider using D6194 for implant-supported retainers instead.

Insurance Billing Tips

To optimize reimbursement and minimize denials when billing D6195:

• Verify coverage: Confirm the patient’s plan covers implant-related procedures and specifically abutment-supported prosthetics.
• Pre-authorization: Submit a detailed pre-treatment estimate with supporting documentation, including radiographs and a narrative.
• Accurate coding: Ensure you’re not confusing D6195 with similar codes, such as D6194 or D6056 (abutment placement).
• Attach supporting evidence: Always include clinical photos, radiographs, and detailed narratives with your claim.
• Track EOBs and AR: Monitor Explanation of Benefits (EOBs) for underpayments or denials, and be ready to appeal with additional documentation if needed.

Successful dental offices make insurance verification and documentation a routine part of their implant workflow, reducing delays and improving collections.

Example Case for D6195

Case: A patient is missing teeth #19 and #20. Two implants are placed, and custom abutments are attached. A three-unit fixed bridge is fabricated, with retainers on the abutments of both implants and a pontic replacing tooth #20. For the retainers seated on the abutments, D6195 is billed for each abutment-supported retainer. Documentation includes pre-op and post-op radiographs, a narrative describing the treatment plan, and photos of the final prosthesis. The claim is submitted with all supporting materials, and the insurance carrier reimburses according to the patient’s plan.

This example highlights the importance of precise coding, thorough documentation, and proactive insurance communication when billing for abutment-supported retainers using D6195.