Dental code hybrid denture

What is dental code hybrid denture? 2015 ADA codes

This post covers dental codes for both hybrid dentures, bars and over-dentures, locators/ERA dentures and implant supported full arch bridges.  For those of us providing FFS care, the codes are kind of irrelevant because we are maxing out any dental insurance plan and the cost is mostly out-of-pocket.  These codes would matter to someone in-network providing this service.  For those working on in-network patients, the doctor needs to study the fee schedule closely to ensure that the procedure can be done without them losing thousands of dollars on it.  Many plans make it financially impossible for in-network dentists to provide this kind of treatment.  To learn some of the differences and treatment planning involved in deciding which one to do you can check out all my blogs on the topic of implant supported and retained dentures here.

All on 4 or hybrid denture dental code

These dental codes are used for a traditional all on 4 or all on more denture.  This would use acrylic, composite (like Gradia gum), and/or nanohybrid denture teeth.  These are nearly always screw retained and only removable by the doctor.  I have heard that if you are an in-network doctor the fees you can charge for this make it impossible to provide.  In that case use the implant supported bridge dental codes found below and do the whole thing like a bridge.  That will be more expensive but not by much and you will be able to charge the patient a fee that is fair.

D6056? per each multi-unit abutment

D6114 or D6115 depending on which dental arch

D6118 or D6119 is what can use if doing a screw retained temporary at any point during the process, usually this would be for the temporary that we give the patient the day of surgery.

Full mouth implant supported bridge dental code

dental code hybrid dentureThis could be either traditional crown and bridge on dental implants or full arch prosthesis that is attached to multi-unit abutments.  This could look like a hybrid denture but be metal and ceramic instead of metal and acrylic.  It could be screwed, cemented, or a combination.  So could be non-removable or doctor removable, but not patient removable.

Depending on what abutments you use

D6056? per each multi-unit abutment      D6056 per each stock abutment     D6057 per each custom abutment

D6068-72 (depending on material used) Abutment supported retainer crown.  Essentially one per each implant.

D6210-45 (depending on material used)  Pontic.  Number of total teeth – number of codes above used = Number of times this code is used.

Implant Supported Overdenture dental code

This would traditionally have a bar.  It is only considered supported if none of the support comes from tissue.  If some support comes from tissue, as in the next group, it is retained overdenture.  An overdenture can be implant supported just on abutments as well, without a bar.  These have different names and may be confusing.  A true telescope will often get support from tissue as well as the abutments and is thus not supported.  A konus or conus (like syncone) has a fixed stop and is entirely implant supported.  The difference between conus and telescope can be found here.

D5862 per each Precision attachment (set of male and female components reported as one precision attachment).  These would include the syncone abutments and locator abutments on top of a bar.  I do not believe that the attachments are considered part of the bar.

D6055 the connecting bar

D6110 for maxilla and D6111 for mandible is the denture code that goes over bar or abutments.  This is totally supported by implants and abutments not tissue support!

Implant retained denture dental code = Locator denture dental code

This would be a locator or ERA retained denture.  These would be dentures that are retained by implants (actually some type of abutments), but are supported by tissue as well as the implants.

D5862 per each Precision attachment (set of male and female components reported as one precision attachment) (so locator or ERA)

D5110 or D5120 denture might be easier to use but D5863 or D5865 Complete Overdenture is the correct code.

 

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28 Responses to “Dental code hybrid denture”

  1. ElizabethJanuary 4, 2018 at 7:26 pm #

    Thank you! This info is extremely helpful! I want to bill this correctly, and we are in In-Network provider, so the contracted rates definitely need to be taken into consideration because of the high lab bill.

  2. MariaMarch 9, 2018 at 8:48 pm #

    I need help with converting the following dental codes to medical codes for reimbursement. Please help.

    D6057
    D6114
    D6115
    D7952
    D7951
    D6104

    • Bauer BryanMarch 12, 2018 at 5:35 am #

      Even with serious help that is a very tough sell. Not only do you need the codes you need narratives. There are medical coding for dentistry companies that help but few can make it actually work.

  3. Jorge AnguloApril 18, 2018 at 12:05 pm #

    We are struggling with putting together a treatment plan for a patient who is in network but has exhausted her benefits for the year.
    My intention is for her final prosthesis to be acrylic with denture teeth. My lab can make it out of zirconia but I am convince acrylic is the way to go. I’m debating my office manage because I feel it is insurance fraud to code for PFMs when there is no metal (well the substructure) or porcelain involved.
    I’m urging her to present a flat fee and have the patient take it or leave it.
    The other option is to do zirconia and I won’t feel as guilty.

    • Bauer BryanApril 18, 2018 at 11:51 pm #

      I agree with your thoughts. Big fee and take it or leave it.

  4. Roger DurantMay 3, 2018 at 2:18 pm #

    What is dental codes for Mandible and Maxillary Dentures locator?

    • Bauer BryanMay 3, 2018 at 8:05 pm #

      The last paragraph

  5. Angi AmosMay 8, 2018 at 9:48 pm #

    What is a code for the O ring

    • Bauer BryanMay 9, 2018 at 11:11 pm #

      That is a semi precious attachment. So it’s that code – same as a locator.

  6. Lisa McDermottMay 10, 2018 at 4:05 pm #

    How may units can be billed for D6116? Is it once for the arch? Thank you.

    • Bauer BryanMay 10, 2018 at 8:02 pm #

      You bill however many you deliver. It’s almost certainly just one per arch but if you were delivering two separate units per arch I guess it could theoretically be two. Are you sure this is the code you want? You are screw retaining a partial denture to implants?

  7. Lisa McDermottMay 10, 2018 at 10:59 pm #

    Yes, thank you for the clarification.

  8. TJ WhitkaerMay 29, 2018 at 5:32 pm #

    Would you use 6110(max) and 6111(mand) along with 5862 for precision attachments for each abutment as well as charge out for a custom abutment 6057 for Conus system? Thank you

    • Bauer BryanMay 29, 2018 at 8:41 pm #

      The abutments aren’t really custom are they? They are stock I thought, haven’t used so maybe they are custom. Anyway you need to pick one or the other, either semi-precision attachment or custom abutment. You could have a custom abutment with a semi-precision attachemnt welded onto the top in some instances but I’m guessing that’s not what you are talking about. You can see some custom abutments with locators on top on my implant overdenture page.

  9. DonnaMarch 27, 2019 at 1:50 pm #

    How much does it cost for a full hybrid denture top andbottom

    • Bauer BryanMarch 31, 2019 at 9:12 pm #

      The cheapest you can do it is about $40,000. If you want metal and porcelain teeth instead that adds another $10,000.

  10. CherylMay 13, 2019 at 7:19 pm #

    As an in network provider for insurances, how it is possible to cover the high cost of the lab bill when you are required to discount down to the insurance fees? If the patient has insurance and you bill them you are losing money and cannot charge the patient for any additional fees. Are you able to set forth a treatment plan for all on 4 for the patient and not bill their insurance?

    • Bauer BryanMay 14, 2019 at 10:57 pm #

      There is a bunch of little tricks that I know docs use but I don’t know the specifics and I don’t think they are not breaking the contracts you sign with the insurance company. I’m not in network with anyone so I only know the basics of what I hear. Most just tell the patient they can’t do it at what the insurance pays and they are welcome to go elsewhere or sign off that they will not be utilizing their insurance. There exists some paperwork but I image it is only effective as long as patient doesn’t come back and complain to insurance company.

  11. JacobMay 27, 2019 at 3:48 am #

    Thank you very much for your info! Very helpful. Trying to understand a little better the coding for the hybrid portion. Let’s use maxillary over 4 as example. Are you saying you will use D6114, D6056(x4), D6068(x4), D6245(x8) if making prosthesis in zirconia? Or are you only using the D6114 for the whole unit? Hope this makes sense. Thanks again.

    • Bauer BryanMay 29, 2019 at 8:27 pm #

      I would only use the crown codes if you are doing a prosthesis with individual teeth usually that would be on a metal or trilor type framework. If pure zirconia then you could only use 6056 for the MUA, which the surgeon usually places so if you are not doing surgery you probably can not code for that. You might be able to get the lab to do the framework with a few preps on it instead of just one piece and then you or the lab lute them on. That would allow you to use individual crown codes. You could probably do what you are saying and be fine though also. I don’t think insurance companies are going to crack down on you for that as in my mind you could defend that as being accurate as well.

  12. HeatherAugust 14, 2019 at 6:08 pm #

    Hello, I have a patient who is needing 4 mandibular implants for a removable RPD. He will be going to the oral surgeon for his implants but we will be doing locator and abutment. Would it be correct to use codes D5862 and D6057?

    • Bauer BryanAugust 14, 2019 at 7:47 pm #

      No. It would be one or the other plus your denture code. Most likely you will just be ordering the locators so will not be any customizing there. Then either dentist or lab will pick up the female portion in the denture. I prefer to pick up myself.

  13. MikeSeptember 5, 2019 at 5:48 pm #

    I am confused as to how to bill this with insurance. It seems to me that D6114 and D6115 are essentially dentures that screw into the implants. They are acrylic with acrylic teeth. Since I am using a trilor frame with separate zirconia or EMax teeth I would think I could bill out for a fixed bridge. Abutments, crowns, pontics. Thoughts?

    • Bauer BryanSeptember 5, 2019 at 10:06 pm #

      Yes you are right. I would bill out the abutments on whatever implants you have and then the rest as implants crowns and pontics. Insurance will max out quick on that. If you are FFS don’t even worry about it though. If PPO you will want to get creative with coding.

  14. KristinSeptember 7, 2019 at 12:02 am #

    When splitting a procedure between an Oral Surgeon and a Prosthoedontis, who is responsible for billing the D6056 Abutments? I had assumed it was the Oral surgeon’s portion and included as a part of the D6010 Implant Procedure?

    • Bauer BryanSeptember 17, 2019 at 6:10 pm #

      Depends. Everyone does it differnt

    • Bauer BryanSeptember 17, 2019 at 6:10 pm #

      Depends. Everyone does it different

  15. charles epie sone ajangSeptember 9, 2019 at 9:49 am #

    i need to have a detachable tooth sticker. what is the cost price

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