Understanding Dental Code D8680

When to Use D8680 dental code

The D8680 dental code is designated for "orthodontic retention (removal of appliances, construction and placement of retainer(s))." Dental offices should use D8680 when a patient completes active orthodontic treatment and the provider removes fixed appliances (such as braces) and fabricates and delivers a retainer to maintain the achieved tooth alignment. This code is not for periodic retainer checks or repairs—its use is specific to the initial removal and delivery of retainers post-treatment.

Documentation and Clinical Scenarios

Accurate documentation is essential for proper billing and claim approval. Clinical notes should clearly state:

• Date of appliance removal
• Details of the retainer(s) constructed and delivered (e.g., upper, lower, type of retainer)
• Confirmation that the patient completed active orthodontic therapy
• Any relevant pre- and post-treatment photos or models

Common clinical scenarios for D8680 include:

• Completion of traditional braces with subsequent delivery of clear or Hawley retainers
• Removal of aligner attachments and provision of retention appliances after clear aligner therapy

Insurance Billing Tips

When billing D8680, follow these best practices to maximize claim acceptance and minimize denials:

• Verify orthodontic benefits: Confirm with the payer if retention is a covered benefit and whether it is included in the comprehensive orthodontic case or billed separately.
• Submit supporting documentation: Attach clinical notes, treatment completion records, and photos/models as evidence of service completion.
• Use precise coding: Do not use D8680 for retainer repairs or for periodic retainer checks.
• Review EOBs: Carefully check Explanation of Benefits for bundling or frequency limitations. Some plans may consider D8680 part of the global orthodontic fee.
• Appeal if necessary: If a claim is denied, submit a detailed appeal with documentation showing the medical necessity and timing of the retention phase.

Example Case for D8680

Scenario: A 15-year-old patient completes 24 months of comprehensive orthodontic treatment with fixed appliances. On the day of debonding, the orthodontist removes the braces, takes impressions, and delivers upper and lower clear retainers. The clinical note documents the removal, retainer delivery, and patient instructions for retainer wear. The office bills D8680 for the removal and placement of retainers, attaching the final treatment summary and photos to the claim. The insurance carrier processes the claim as a covered benefit under the patient’s orthodontic plan.

This example highlights the importance of thorough documentation, correct code selection, and proactive insurance communication to ensure timely reimbursement for orthodontic retention services.