Understanding Dental Code D6212

When to Use D6212 dental code

The D6212 dental code is a CDT (Current Dental Terminology) code specifically designated for a pontic made of titanium and titanium alloys. A pontic is the artificial tooth in a fixed partial denture (bridge) that replaces a missing tooth. D6212 is used when the restorative material is titanium, which is known for its strength, durability, and biocompatibility. This code should be selected when the clinical situation calls for a titanium pontic, such as in patients with metal allergies or when superior strength is required in the prosthesis.

Documentation and Clinical Scenarios

Accurate documentation is essential for successful reimbursement and compliance. When submitting a claim for D6212, ensure the patient’s chart clearly indicates:

• The edentulous space (missing tooth area) being restored
• The clinical rationale for choosing a titanium pontic (e.g., patient allergy to other metals, need for enhanced strength)
• Pre-operative and post-operative radiographs or intraoral photos
• Detailed notes on the design and material selection

Common clinical scenarios include full-arch implant-supported bridges, cases requiring hypoallergenic materials, or situations where a high-strength prosthesis is necessary due to occlusal forces.

Insurance Billing Tips

To maximize reimbursement and minimize denials when billing D6212, follow these best practices:

• Verify coverage: Confirm with the payer that the patient’s plan covers titanium pontics. Not all plans will cover this material, and some may require pre-authorization.
• Submit supporting documentation: Include clinical notes, radiographs, and a narrative explaining the necessity of a titanium pontic. Attach manufacturer details if requested by the payer.
• Use correct CDT codes: Ensure D6212 is not confused with other pontic codes such as D6205 (pontic, all-ceramic) or D6210 (pontic, cast high noble metal). Select the code that matches the actual material used.
• Appeal denials: If a claim is denied, review the Explanation of Benefits (EOB) for the reason and submit a detailed appeal with additional documentation as needed.

Example Case for D6212

Consider a patient missing a mandibular first molar with a history of allergic reactions to nickel-based alloys. After discussing restorative options, the dentist and patient agree on a fixed bridge with a titanium pontic for biocompatibility. The treatment plan is documented, pre-op radiographs are taken, and a narrative is prepared explaining the material choice. The claim is submitted with D6212, including all supporting documentation. Insurance initially requests more information, so the office promptly sends manufacturer specs and additional clinical notes. The claim is approved, and the office receives payment without further delay.

This real-world workflow highlights the importance of thorough documentation, proactive communication with payers, and understanding the nuances of CDT code selection for optimal revenue cycle management.