Understanding Dental Code D6740

When to Use D6740 dental code

The D6740 dental code is designated for a retainer crown that is part of a fixed partial denture (FPD), commonly known as a bridge. This code is used when a crown serves as an abutment to support a pontic (artificial tooth) within a bridge, rather than as a standalone restoration. It is important to distinguish D6740 from codes for single-unit crowns or other bridge components to ensure accurate billing and avoid claim denials. Use D6740 when the clinical scenario involves replacing a missing tooth with a bridge, and the crown is fabricated to anchor the prosthesis to adjacent natural teeth or implants.

Documentation and Clinical Scenarios

Proper documentation is critical for successful reimbursement when billing D6740. The clinical notes should clearly indicate:

• The presence of a missing tooth or teeth requiring a fixed bridge.
• The teeth being used as abutments and their condition (e.g., healthy, periodontally stable).
• Radiographs or intraoral images showing the edentulous space and abutment teeth.
• The design and material of the retainer crown (e.g., porcelain/ceramic, metal-ceramic).

Common clinical scenarios include:

• Replacing a single missing tooth with a three-unit bridge, where D6740 is billed for each abutment crown.
• Restoring multiple missing teeth with a multi-unit FPD, with D6740 applied to each retainer crown supporting the bridge.

Insurance Billing Tips

To maximize reimbursement and minimize delays, follow these best practices when billing D6740:

• Pre-authorization: Submit a pre-treatment estimate with supporting documentation (radiographs, perio charting, narrative) to confirm coverage before starting treatment.
• Accurate coding: Use D6740 only for retainer crowns as part of a bridge. For single crowns, use the appropriate crown code such as porcelain fused to metal crown.
• Detailed narratives: Include a concise narrative explaining the need for a fixed bridge, the abutment teeth involved, and why a retainer crown is necessary.
• Coordination of benefits: If the patient has dual insurance, verify primary and secondary coverage and submit claims accordingly to avoid payment delays.
• Appeals: If a claim is denied, review the EOB for the denial reason, gather additional documentation, and submit a timely appeal with a detailed explanation and supporting evidence.

Example Case for D6740

Case Study: A patient presents with a missing upper right first molar (#3). The adjacent teeth (#2 and #4) are healthy and suitable for use as abutments. The treatment plan involves a three-unit bridge, with retainer crowns on #2 and #4 and a pontic replacing #3. For billing, D6740 is used for both #2 and #4, while the pontic is billed under the appropriate pontic code. The clinical documentation includes pre-op radiographs, a narrative detailing the bridge design, and confirmation of abutment tooth stability. The claim is submitted with all required documentation, resulting in prompt approval and payment.