Can D6242 be used for multiple missing teeth?

D6242 is typically used for single tooth replacement within a bridge; multiple pontics would require additional codes.

Is D6242 covered by insurance?

Coverage varies by insurance plan; it's important to verify with the patient's provider for specific coverage details.

What are the alternatives to a porcelain fused to noble metal pontic?

Alternatives include all-ceramic pontics or those fused to base metals, depending on the clinical needs and patient preferences.

How long does a porcelain fused to noble metal pontic last?

With proper care, these pontics can last many years, but longevity depends on factors like oral hygiene and material quality.

D6242

Pontic Porcelain Fused to Noble Metal - CDT Code Guide

Prosthodontics, fixed/Fixed Partial Denture Pontics

Overview

CDT Code D6242 refers to a pontic made of porcelain fused to a noble metal, used in fixed partial dentures. This procedure involves creating a prosthetic tooth that is anchored between two crowns, typically used to replace a missing tooth in a dental bridge. The porcelain provides a natural appearance, while the noble metal offers strength and durability. This code is often used in scenarios where aesthetics are a priority, and the patient requires a durable solution for tooth replacement. Dental professionals utilize this code when fabricating a fixed partial denture that involves a pontic designed to blend seamlessly with the patient's natural teeth.

When to Use This Code

When replacing a single missing tooth with a fixed bridge.
In cases where aesthetics are important, and a natural-looking pontic is desired.
When the patient has adjacent teeth that can support a fixed partial denture.
For patients requiring a durable solution with a strong metal substructure.
In scenarios where the patient prefers a non-removable tooth replacement option.

Documentation Requirements

Detailed patient chart notes indicating the need for a pontic.
Pre-operative and post-operative radiographs showing the treatment area.
Documentation of the materials used, including the type of noble metal.
Patient consent forms outlining the procedure and materials used.
A detailed treatment plan explaining the choice of a porcelain fused to noble metal pontic.

Billing Considerations

When billing for D6242, ensure the procedure is documented thoroughly to justify the use of a noble metal. Be aware of insurance policies regarding frequency limitations for prosthodontic procedures. Common modifiers may include those indicating a replacement or repair. Verify with the patient's insurance for coverage specifics, as some plans may have restrictions on the use of noble metals.

Related CDT Codes

D6240 D6241 D6750 D6751 D6792

Frequently Asked Questions

The main advantage is the combination of aesthetic appeal and strength, offering a natural look with durable support.

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