Pontic Indirect Resin Based Composite - CDT Code Guide
Overview
CDT Code D6205 refers to a pontic made from an indirect resin-based composite material, used in fixed partial dentures. This type of pontic is not intended for temporary or provisional use, making it a durable option for patients requiring a long-term solution. The procedure involves crafting a pontic that replaces a missing tooth, anchored by adjacent teeth or implants. Indirect resin-based composites are chosen for their aesthetic qualities and strength, providing a natural look that blends seamlessly with existing teeth. This code is typically used in scenarios where a patient has lost a tooth due to decay or trauma and requires a fixed prosthetic solution to restore function and appearance.
When to Use This Code
- When a patient requires a permanent pontic for a fixed partial denture.
- In cases where aesthetics are a priority, and a resin-based composite is preferred.
- When replacing a single missing tooth in a non-load-bearing area.
- For patients who are allergic to metal and require a metal-free prosthesis.
- In scenarios where a temporary or provisional solution is not suitable.
Documentation Requirements
- Detailed patient dental history and examination notes.
- Radiographic evidence supporting the need for a pontic.
- Documentation of the materials used in the pontic fabrication.
- Clinical notes on the procedure and patient consent forms.
- Post-procedure follow-up notes and patient feedback.
- Insurance pre-authorization if required by the patient's plan.
Billing Considerations
When billing for D6205, ensure that the procedure is not billed as a temporary solution. Check the patient's insurance plan for coverage limitations on resin-based composites. Common modifiers may include those indicating the quadrant or arch. Frequency limitations may apply, so verify the patient's history of similar procedures.
Related CDT Codes
Frequently Asked Questions
No, D6205 is specifically for permanent pontics and should not be used for temporary or provisional prostheses.
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