Understanding Dental Code D6720

When to Use D6720 dental code

The D6720 dental code is used to report a retainer crown for a fixed partial denture (commonly known as a bridge). Specifically, D6720 refers to a retainer crown made of high noble metal, which serves as an anchor (retainer) for the prosthetic bridge. This code is appropriate when a patient requires a fixed bridge and the abutment tooth is being restored with a full cast high noble metal crown to support the prosthesis. Correct use of D6720 ensures accurate billing and proper reimbursement for the materials and expertise involved in these restorative cases.

Documentation and Clinical Scenarios

Accurate documentation is essential when billing D6720. Dental teams should include:

• Detailed clinical notes describing the need for a fixed partial denture and the selection of a high noble metal retainer crown.
• Pre-operative radiographs showing the abutment tooth’s condition and suitability for a retainer crown.
• Intraoral photographs, if available, to further support the clinical decision.
• Material specifications indicating the use of high noble metal.

Common clinical scenarios for D6720 include replacing a missing tooth with a bridge when the adjacent tooth is healthy enough to serve as an abutment and requires a full cast crown for retention. If a different material is used (such as base metal or porcelain fused to metal), reference the appropriate CDT code, such as D6750 for porcelain fused to high noble metal retainer crowns.

Insurance Billing Tips

To maximize reimbursement and minimize claim denials for D6720, follow these best practices:

• Insurance Verification: Confirm the patient’s coverage for fixed partial dentures and high noble metal crowns before treatment. Note frequency limitations, waiting periods, and replacement intervals.
• Pre-Authorization: Submit a pre-authorization with supporting documentation (radiographs, clinical notes, and material details) to establish medical necessity and avoid surprises for the patient and practice.
• Claim Submission: Clearly indicate D6720 on the claim form, attach all supporting documents, and specify the tooth number and location of the retainer crown.
• Explanation of Benefits (EOB) Review: Carefully review the EOB for payment accuracy and note any downgrades or alternate benefit clauses. If underpaid or denied, prepare a claim appeal with additional documentation as needed.

Staying proactive in communication with payers and patients helps maintain a healthy accounts receivable (AR) and improves the practice’s revenue cycle management (RCM).

Example Case for D6720

Case Study: A patient presents with a missing lower first molar (#19). The adjacent teeth (#18 and #20) are healthy but require full coverage to support a fixed bridge. After discussing options, the dentist recommends a three-unit bridge with a high noble metal retainer crown on #18 (D6720), a pontic for #19, and a retainer crown on #20. The treatment plan, radiographs, and material choice are documented. The insurance coordinator verifies coverage, submits a pre-authorization, and receives approval. Upon completion, the claim is submitted with all required documentation, resulting in timely reimbursement with no denials.

This scenario highlights the importance of precise coding, thorough documentation, and diligent insurance workflows in successfully billing for D6720.