Dental Coding for Cleaning Teeth, Implants, and Dentures
A common question we receive: “How should we code for cleanings when a patient has implants or dentures instead of natural teeth?” Let’s review a few scenarios and how to correctly code for each situation.
Cleaning Natural and Implant Teeth
In the past, confusion arose from the slightly vague coding for a prophy, D1110, which before 2021 read:
“Removal of plaque, calculus, and stains from the tooth structures in the permanent and transitional dentitions. It is intended to control local irritational factors.”
Implants were intended under the term permanent, but since that was not specified many questions arose.
The D1110 code was modified in 2021 to include implants into the description for more clarity.
D1110 - Removal of plaque, calculus, and stains from the tooth structures and implants in the permanent and transitional dentitions. It is intended to control local irritational factors.
Any number of implants or natural teeth with healthy periodontium would mean using the D1110 dental code.
If any of the implants and/or teeth have periodontal bone loss and a history of scaling and root planing (SRP), then a D4910 would be the more appropriate code to use. Remember, in general the D4910 cannot follow a D1110.
What About the D6080 Implant Maintenance code?
D6080 has the description: “Implant maintenance procedure when prostheses are removed and reinserted, including cleaning of prostheses and abutments.”
The removal and reinsertion of the prothesis is the key here. If you are not removing the restoration, then D6080 would not apply.
Ex: tightening a screw on a screw-retained crown would involve neither removal nor cleaning of the crown and would therefore not be coded D6080.
How Would One Code for Cleaning a Hybrid Denture or All-On-Four?
If you are not removing the prosthetic, you would code either D1110 or D4910 based on the health of the periodontium.
If you are removing the prosthetic, you would want to code for not only the removal and cleaning process (D6080), but also the replacement of any screws (internal code as no ADA code exists for this). If you are placing any permanent restorative material (ex: composite) in the access, also use:
D6197 - Replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis, per implant.
Using any kind of impression material or Teflon would not justify the D6197 code.
If you want more information on internal coding, please check out the recorded Q&A session in the office hours section.
How About Dental Coding for Cleaning Removable Dentures?
These dental codes were added to the CDT in 2016 to help:
D9932—cleaning and inspection of removable complete denture, maxillary
D9933—cleaning and inspection of removable complete denture, mandibular
D9934—cleaning and inspection of removable partial denture, maxillary
D9935—cleaning and inspection of removable partial denture, mandibular
If you are replacing the locators, use D6091 - Replacement of replaceable part of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis, per attachment.
While these codes do exist and can be used, many policies are not reimbursing for the service. These codes are therefore mostly for patient billing. You can still file the code for the patient to try to help. But it would help to avoid surprising the patient with an unexpected bill later when the code was predictably not reimbursed and just go ahead and charge the patient up front.
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