Comprehensive Guide to D6110 Dental Code and Implant Prosthetics

What dental code is D6110?

D6110 is the dental code for a maxillary removable complete denture that is supported by implants. This is also known as a maxillary implant overdenture. The code is officially known as “implant /abutment supported removable denture for edentulous arch – maxillary.”

Frequently Asked Questions About D6110 Dental Code

What procedure does D6110 refer to?

The D6110 code refers to the placement of an implant/abutment-supported removable denture for the maxillary (upper) arch. This type of denture is anchored to implants in the jawbone, providing increased stability and retention compared to traditional dentures.

What are the documentation requirements and best practices for D6110?

  • Document the clinical indications for the implant-supported denture, including patient symptoms and diagnosis.
  • Include pre-operative radiographs and imaging studies to show bone structure and implant sites.
  • Record detailed notes on the surgical procedure for implant placement and the fitting of the denture.
  • Maintain thorough records of follow-up visits and any adjustments made to the denture.

What are the typical reimbursement rates and guidelines for D6110?

  • Reimbursement rates typically range from $3,000 to $5,000, depending on the insurance provider and the complexity of the case.
  • Guidelines often require documentation of the medical necessity for the implant-supported denture and may include pre-authorization.
  • Ensure to check the specific policies of the insurance company regarding frequency and coverage limits.

Are there any common errors or pitfalls to avoid with D6110?

  • Common errors include insufficient documentation of the necessity for the implant-supported denture.
  • Avoid coding errors by ensuring the correct identification of the maxillary arch.
  • Ensure all components of the procedure, including implant placement and denture fitting, are accurately documented.

How should D6110 be submitted on an insurance claim, and what modifiers are required?

  • Submit the D6110 code with comprehensive clinical notes justifying the procedure.
  • Typically, no specific modifiers are required unless specified by the insurer.
  • Ensure the claim form includes detailed descriptions of the surgical and prosthetic components of the treatment.

Is D6110 often used with other codes, and how does it fit into the overall coding system?

  • D6110 is often used with codes for diagnostic evaluations (D0150), imaging (D0367), and other implant procedures such as D6010 (surgical placement of implant body).
  • It fits within the broader category of implant-supported prosthetics and restorative dentistry.

How can I verify patient eligibility and coverage for this procedure?

  • Contact the patient’s insurance provider to verify coverage for the implant-supported denture.
  • Confirm any pre-authorization requirements and frequency limitations.
  • Check for specific documentation requirements needed to demonstrate medical necessity for the procedure.

What are the ethical considerations and common fraud indicators associated with D6110?

  • Ensure the implant-supported denture is clinically justified and thoroughly documented.
  • Be cautious of overusing D6110 for procedures that do not meet the criteria for implant-supported dentures.
  • Watch for signs of fraud, such as billing for implants not placed or unnecessary procedures.

What are the key differences between similar codes?

  • D6110 is for implant/abutment-supported removable dentures for the maxillary arch, whereas D6111 is for the mandibular (lower) arch.
  • D6010 covers the surgical placement of the implant body itself, which is a component of the overall treatment involving D6110.

Why was D6110 specifically used for my treatment, and are there alternative treatments with different codes and costs?

  • D6110 was chosen because you require a stable and functional removable denture for the upper arch, supported by dental implants.
  • Alternatives include traditional removable dentures (D5110) or fixed implant-supported prostheses (D6055), each offering different benefits and costs.
  • Your dentist determined that an implant-supported removable denture was the most appropriate and cost-effective solution based on your oral health needs and preferences.

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