Complete Guide to D9120 Dental Code for Sectioning Bridges

What ADA CDT dental code is D9120?

D9120 is the ADA CDT dental code for sectioning a bridge or fixed partial denture (FPD). This is typically the section bridge ADA dental code and applies when a clinician sections and removes part of a bridge. This occurs when a portion of the prosthesis is planning to be kept and is still serviceable. The code is officially known as “fixed partial denture sectioning.”

Frequently Asked Questions for D9120 Dental Code

What procedure does D9120 refer to?

The dental code D9120 refers to the procedure of fixed partial denture sectioning. This involves cutting or separating a fixed partial denture (also known as a bridge) to remove a section or to facilitate further treatment. This procedure is typically performed when part of the bridge needs to be removed while preserving the rest.

What are the documentation requirements and best practices for D9120?

  • Detailed clinical notes describing the reason for sectioning the fixed partial denture.
  • Preoperative and postoperative radiographs to document the condition of the denture and the results of the procedure.
  • A narrative that explains the need for sectioning, such as decay under a pontic or abutment, or preparation for additional procedures.
  • Consent forms signed by the patient indicating their understanding of the procedure and its implications.

What are the typical reimbursement rates and guidelines for D9120?

Reimbursement for D9120 can vary based on the insurance provider and geographic location. Typically, insurance may cover 50-80% of the cost, with average reimbursement rates ranging from $150 to $350. It is important to verify with specific insurance carriers as rates and coverage can differ.

Are there any common errors or pitfalls to avoid with D9120?

  • Ensure accurate documentation that clearly supports the necessity of the procedure.
  • Avoid coding errors such as using D9120 for the complete removal of a bridge when other codes might be more appropriate.
  • Double-check the patient’s dental history and radiographs to justify the procedure.

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

  • Include the correct tooth numbers involved in the procedure.
  • Generally, no additional modifiers are required, but always confirm with the specific insurance provider’s guidelines.
  • Complete the claim form accurately to avoid processing delays.

Is D9120 often used with other codes, and how does it fit into the overall coding system?

D9120 may be used in conjunction with other procedures as part of a comprehensive treatment plan. For example, it could be followed by codes for restorative procedures or implant placement after sectioning the bridge. Understanding how D9120 integrates with other dental codes can help in accurate treatment planning and billing.

How can I verify patient eligibility and coverage for D9120?

  • Utilize electronic verification tools provided by insurance companies to check coverage details.
  • Contact the insurance provider directly to confirm specifics of coverage for fixed partial denture sectioning.
  • Review the patient’s policy for any waiting periods, maximum coverage limits, and specific exclusions.

What are the ethical considerations and common fraud indicators associated with D9120?

  • Use D9120 only when clinically necessary and justified by the patient’s condition.
  • Maintain transparency with patients regarding the need for the procedure and associated costs.
  • Be vigilant for signs of fraudulent activity, such as unnecessary sectioning or inconsistent documentation.

What are the key differences between codes similar to D9120?

D9110: Palliative (emergency) treatment of dental pain. This code is used for pain management and not for sectioning dentures.
D9120: Fixed partial denture sectioning. Specific to separating a fixed partial denture.
D9215: Local anesthesia in conjunction with operative or surgical procedures. Used for anesthesia purposes and not directly related to sectioning.

Why was D9120 specifically used for my treatment, and are there alternative treatments with different codes and costs?

D9120 was selected because part of your fixed partial denture required sectioning due to decay, damage, or preparation for further treatment. Alternative treatments may include:

  • D2950: Core buildup, including any pins, for a restorative base if further tooth restoration is needed.
  • D6240: Pontic – porcelain fused to high noble metal, if a new pontic is needed as part of bridge work.
  • D7210: Surgical removal of erupted tooth requiring elevation of mucoperiosteal flap and removal of bone and/or section of tooth.
  • Each option varies in cost and coverage, so discussing these with your dentist will help in understanding the best course of action for your specific case.

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