Pontic Porcelain Fused to Metal - CDT Code Guide
Overview
CDT code D6240 refers to a dental procedure involving the placement of a pontic, which is a false tooth, made of porcelain fused to high noble metal. This procedure is part of fixed prosthodontics and is commonly used in fixed partial dentures (FPDs) to replace missing teeth. The high noble metal provides strength and durability, while the porcelain offers a natural appearance, making it an ideal choice for anterior or visible areas of the mouth. Typically, this procedure is performed when a patient has lost a tooth due to decay, trauma, or periodontal disease, and seeks a long-lasting and aesthetically pleasing solution. The pontic is anchored to adjacent teeth or implants, ensuring stability and functionality.
When to Use This Code
- Replacing a single missing tooth in the anterior region for aesthetic purposes.
- When a patient requires a durable and natural-looking solution for a missing tooth.
- In cases where adjacent teeth are suitable abutments for a fixed partial denture.
- When a patient prefers a fixed solution over removable partial dentures.
- For restoring function and appearance in patients with high aesthetic demands.
Documentation Requirements
- Detailed patient history and diagnosis supporting the need for a pontic.
- Pre-operative and post-operative radiographs showing the treatment area.
- Documentation of the materials used, including the type of high noble metal.
- Clinical notes on the patient's consent and understanding of the procedure.
- Records of the patient's occlusion and any adjustments made post-placement.
- Follow-up notes to monitor the success and integration of the pontic.
Billing Considerations
When billing for D6240, ensure that the procedure is justified by the patient's dental condition and documented thoroughly. Frequency limitations may apply based on the patient's insurance plan, and it is essential to verify coverage for high noble metal components. Common modifiers may include those indicating the quadrant or arch treated. Coordination with insurance providers is crucial to confirm pre-authorization requirements and patient co-pays.
Related CDT Codes
Frequently Asked Questions
A pontic is a false tooth used to replace a missing tooth, while a crown covers and restores a damaged tooth.
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