Pontic Implant Bridge Dental Code
The American Dental Association (ADA) has established a comprehensive coding system to standardize dental procedures, including pontic implant bridges. These codes are essential for dental professionals to ensure accurate billing and insurance claims. The ADA code for a pontic implant bridge typically falls under the category of D6000-D6199, which covers implant services.
Understanding ADA Codes
The ADA codes are alphanumeric and are designed to provide a clear description of the procedure performed. For example, D6010 refers to the surgical placement of an implant body, while D6057 pertains to the custom abutment. The pontic, which is the artificial tooth that replaces the missing tooth, is often coded under D6245 for a pontic made of high noble metal.
Importance of Accurate Coding
Accurate coding is crucial for several reasons:
- Insurance Claims: Proper coding ensures that insurance claims are processed without delays or denials.
- Patient Records: It helps in maintaining accurate patient records, which are essential for future treatments.
- Legal Compliance: Accurate coding ensures compliance with legal and regulatory requirements.
Common ADA Codes for Pontic Implant Bridges
- D6010: Surgical placement of an implant body
- D6057: Custom abutment
- D6245: Pontic – high noble metal
- D6240: Pontic – predominantly base metal
- D6250: Pontic – resin with high noble metal
Pontic Implant Bridge Dental Code Resin
Resin-based pontics are increasingly popular due to their aesthetic appeal and cost-effectiveness. The ADA code for a resin-based pontic is D6250, which specifies a pontic made of resin with high noble metal.
Advantages of Resin Pontics
- Aesthetic Appeal: Resin pontics can be color-matched to the patient’s natural teeth, providing a more natural appearance.
- Cost-Effective: Resin materials are generally less expensive than porcelain or metal alternatives.
- Durability: Modern resin materials are highly durable and can withstand the forces of chewing.
Procedure for Resin Pontic Placement
- Initial Consultation: The dentist evaluates the patient’s oral health and discusses the treatment plan.
- Implant Placement: The implant body is surgically placed in the jawbone.
- Abutment Placement: Once the implant has integrated with the bone, a custom abutment is placed.
- Pontic Fabrication: The resin pontic is fabricated in a dental lab and then attached to the abutment.
Considerations for Resin Pontics
- Material Quality: The quality of the resin material can significantly impact the longevity and appearance of the pontic.
- Patient Care: Patients must maintain good oral hygiene to ensure the longevity of the resin pontic.
Pontic Implant Bridge Dental Code List
Below is a comprehensive list of ADA codes related to pontic implant bridges:
| ADA Code | Description |
|---|---|
| D6010 | Surgical placement of an implant body |
| D6057 | Custom abutment |
| D6245 | Pontic – high noble metal |
| D6240 | Pontic – predominantly base metal |
| D6250 | Pontic – resin with high noble metal |
| D6065 | Implant abutment – porcelain/ceramic |
| D6066 | Implant abutment – zirconia |
| D6104 | Bone graft for implant |
| D6110 | Implant/abutment supported removable denture |
Explanation of Codes
- D6010: This code is used for the surgical placement of the implant body into the jawbone.
- D6057: This code refers to the custom abutment that connects the implant body to the pontic.
- D6245: This code is used for a pontic made of high noble metal, which is known for its durability and biocompatibility.
- D6240: This code refers to a pontic made predominantly of base metal, which is less expensive but equally durable.
- D6250: This code is used for a resin-based pontic with high noble metal, offering a balance between aesthetics and cost.
Pontic Implant Bridge Dental Code on Claim Form
Filling out a dental claim form accurately is crucial for ensuring that the insurance company processes the claim without any issues. Here’s how to correctly list pontic implant bridge codes on a claim form.
Steps to Fill Out a Claim Form
- Patient Information: Ensure that the patient’s name, date of birth, and insurance ID are correctly filled out.
- Provider Information: Include the dentist’s name, address, and NPI number.
- Procedure Codes: List the ADA codes for the procedures performed, such as D6010 for implant placement and D6245 for the pontic.
- Tooth Numbers: Indicate the tooth numbers involved in the procedure.
- Diagnosis Codes: Include the relevant diagnosis codes (ICD-10) that justify the need for the procedure.
- Fee and Payment Information: List the fees for each procedure and the expected payment from the insurance company.
Common Mistakes to Avoid
- Incorrect Codes: Using outdated or incorrect ADA codes can lead to claim denials.
- Missing Information: Ensure that all required fields are filled out to avoid delays.
- Incomplete Documentation: Attach all necessary documentation, such as X-rays and treatment plans, to support the claim.
Example Claim Form
| Field | Information |
|---|---|
| Patient Name | John Doe |
| Date of Birth | 01/01/1980 |
| Insurance ID | 123456789 |
| Provider Name | Dr. Jane Smith |
| NPI Number | 987654321 |
| Procedure Codes | D6010, D6245 |
| Tooth Numbers | 12, 13 |
| Diagnosis Codes | K08.1 (Loss of teeth due to accident) |
| Fees | $2000 |
| Expected Payment | $1500 |
Conclusion
Pontic implant bridges are a vital solution for replacing missing teeth, and understanding the associated ADA codes is essential for accurate billing and insurance claims. Whether you’re a dental professional or a patient, this guide provides a comprehensive overview of the codes, procedures, and considerations involved in pontic implant bridges.
FAQs
1. What is the ADA code for a resin pontic?
The ADA code for a resin pontic is D6250.
2. How do I ensure my insurance claim is processed without issues?
Ensure that all patient and provider information is accurate, use the correct ADA codes, and attach all necessary documentation.
3. What are the advantages of resin pontics?
Resin pontics offer aesthetic appeal, cost-effectiveness, and durability.
4. Can I use multiple ADA codes on a single claim form?
Yes, you can list multiple ADA codes if multiple procedures are performed.
5. What is the difference between D6245 and D6240?
D6245 refers to a pontic made of high noble metal, while D6240 refers to a pontic made predominantly of base metal.
Additional Resources
- American Dental Association (ADA): www.ada.org
- Dental Coding Manual: Available for purchase on the ADA website.
- ICD-10 Codes: www.cdc.gov/nchs/icd/icd10cm.htm
