Retainer Onlay Cast Base Metal - CDT Code Guide
Overview
CDT code D6613 refers to a dental procedure involving the fabrication and placement of a retainer onlay cast predominantly from base metal, covering three or more surfaces. This procedure is typically part of a fixed partial denture system, where the onlay serves as a retainer to support the prosthesis. The use of base metal alloys is common due to their strength and cost-effectiveness, making them suitable for patients requiring durable dental restorations. Clinically, this procedure is indicated when there is a need to restore the function and aesthetics of a tooth that is part of a fixed bridge, ensuring stability and longevity of the dental appliance.
When to Use This Code
- When a patient requires a fixed partial denture and the abutment tooth needs reinforcement.
- In cases where a tooth has significant structural damage but retains enough integrity to support an onlay.
- When a cost-effective solution is necessary for a durable dental restoration.
- For patients with metal allergies, alternative materials may be considered, but base metal is often used for its strength.
- When the restoration involves three or more surfaces of the tooth.
Documentation Requirements
- Detailed chart notes indicating the necessity for the onlay and its role in the fixed partial denture.
- Pre-operative and post-operative radiographs to document the condition of the abutment tooth.
- A comprehensive treatment plan outlining the materials used and the expected outcomes.
- Patient consent forms acknowledging understanding of the procedure and materials used.
- Lab prescriptions and invoices for the fabrication of the onlay.
Billing Considerations
When billing for D6613, ensure that the procedure is documented as part of a fixed partial denture system. Frequency limitations may apply based on the patient's insurance plan, and it is important to verify coverage for base metal restorations. Common modifiers may include those indicating the quadrant or arch involved. Coordination with insurance providers is crucial to confirm patient benefits and out-of-pocket costs.
Related CDT Codes
Frequently Asked Questions
The primary material used is predominantly base metal, chosen for its strength and cost-effectiveness.
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