Can D6095 be billed with other implant-related procedures?

Yes, but ensure that the repair is not included in a global fee and use appropriate modifiers if necessary.

How often can D6095 be billed for the same patient?

Frequency limitations depend on the patient's insurance policy, so verify with the provider for specific restrictions.

Is prior authorization required for D6095?

This depends on the insurance plan; some may require prior authorization, so it's advisable to check beforehand.

What documentation is necessary for insurance claims involving D6095?

Provide detailed clinical notes, radiographic evidence, and a description of the repair process to support the claim.

D6095

Repair Implant Abutment - CDT Code Guide

Implant Services/Other Implant Services

Overview

CDT code D6095 pertains to the repair or replacement of any part of an implant abutment. This procedure is crucial when an implant abutment, which connects the dental implant to the prosthetic crown, becomes damaged or needs adjustment. Dental professionals may encounter this situation in cases where the abutment has been compromised due to wear, trauma, or improper fit. The repair process can involve tightening, adjusting, or replacing components to ensure the stability and functionality of the dental implant system. Understanding the nuances of this procedure is essential for maintaining the longevity and success of dental implants, providing patients with a reliable and lasting solution for tooth replacement.

When to Use This Code

When an implant abutment is loose or damaged due to trauma.
To replace a worn or defective abutment component.
When adjusting the abutment for better fit or alignment.
If the abutment screw is stripped or broken.
During routine maintenance when minor repairs are needed.

Documentation Requirements

Detailed clinical notes describing the condition of the abutment.
Radiographic evidence supporting the need for repair.
Description of the repair or replacement process performed.
Patient consent for the procedure.
Documentation of any components replaced or adjusted.
Follow-up care instructions provided to the patient.

Billing Considerations

When billing for D6095, ensure that the procedure is not part of a global fee for implant placement or restoration. Check with insurance providers for coverage specifics, as some plans may consider this a part of routine maintenance. Use appropriate modifiers if the repair is performed in conjunction with other procedures. Be aware of frequency limitations, as some insurers may restrict the number of repairs covered within a specific timeframe.

Related CDT Codes

D6057 D6065 D6199 D6058 D6059

Frequently Asked Questions

D6095 includes the repair or replacement of any part of the implant abutment, such as tightening or replacing components.

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