D6058
ABUTMENT SUPPORTED PORCELAIN/CERAMIC CROWN
CDT-2025A single crown restoration that is retained, supported and stabilized by an abutment on an implant.
© 2024 American Dental Association
Warning
- It is misleading to report “implant type” crowns (D60xx) as “routine” individual crowns (D27xx) for natural teeth, solely to increase reimbursement. This may be considered a fraudulent act. Report exactly what you do rather than what may gain a higher reimbursement.
- It is an error to report an “abutment supported” crown code for a screw retained crown that attaches directly to the implant body.
Match
- 3D printed crowns may be reported as porcelain/ceramic provided the material is greater than 50% inorganic fillers.
- Enter the tooth number representing the position of implant being restored in Box 27 of the 2024 ADA Dental Claim Form.
- If an alternate benefit is provided or if covered by an implant policy rider, then reimbursement for “implant type” crowns is typically subject to the five to 10-year limitation period.
- Age, waiting periods, missing tooth clauses, or other limitations may also apply.
Ask for the alternate benefit of a similar material type crown if there is no implant coverage.
Reporting the incorrect type of material (ceramic,high noble, noble, base, etc.) used in fabricating the crown is a common coding error. Be careful to report the correct code based on the material classification. Document the correct material used in the crown on the claim form as represented in the treatment plan, the lab prescription, and the documentation from the lab. Following this protocol should eliminate reporting errors.