by Michael Scherer, DMD, MS, FACP, DABOI/ID
What CDT code should I use for my LOCATOR Overdenture cases!?
The American Dental Association publishes a text of CDT codes and recommends various approaches for how we code appropriately for clinical practices. A question that I get often from clinicians is… “what code do I use for LOCATOR cases?” Great question!! I put together this article to help guide that question! These simple strategies to ensure a clinical practice codes appropriately to ensure the procedural codes are applied correctly to maximize the patient’s insurance coverage.*
A LOCATOR abutment is considered a “semi-precision attachment” and also an “abutment.” While the temptation is to use an “abutment” code such as D6056 or D6051, typically the best code to use for a LOCATOR abutment is D6191. This codes does not include any other parts and is for the abutment only. In certain situations where a custom abutment is used in conjunction with a LOCATOR abutment, clinicians typically can use D6057. Note: custom abutments with genuine LOCATOR abutments should utilize genuine Zest LOCATOR cast-to or threaded components and are available at Zest in the LOCATOR Cast-To & Bar Abutments region. Note: The D6191 code is also utilized for LOCATOR FIXED restorations, since the same abutment can be utilized for both removable fixed restorations!
A LOCATOR Overdenture starts with a dental implant, often something like a Zest LOCATOR implant or any other dental implant that can accept a genuine Zest LOCATOR abutment. Clinicians typically coded as D6010 for standard-diameter implants (≥3.0mm) or D6013 for narrow-diameter implants (<3.0mm).
The LOCATOR Housing (left image, silver part) is embedded within the restoration and is a metal component that holds the LOCATOR inserts (left image, blue/pink/clear). Most clinicians utilize D6192 as the code for the LOCATOR Housing; the initial use of the code includes the initial insert. The D6192 attachment placement code typically is utilized at the same time as the D6191 abutment placement code.
Importantly – the D6091 code is utilized for replacement of just the LOCATOR Insert portion and typically is utilized in conjunction with a recall appointment or hygiene recall appointment.
The inserts periodically need replacement as the patient functions / chews. Typically this is performed when the patient is indicating that the “denture snaps are loose” or “can you make my teeth fit tighter” and typically occurs during recall appointments.
The code most utilized for changing the blue, pink, clear standard range inserts or the red, orange, green LOCATOR extended range inserts is D6091. For LOCATOR R-Tx cases, the same code would apply for the blue, pink, clear standard range and aqua, magenta, and gold limited range inserts. When replacing both the housing and insert, clinicians typically use the D6192 which includes the housings & inserts.
Coding for prosthetics is fairly easy for LOCATOR removable restorations. The code most utilized for maxillary (upper) overdentures is D6110. The code most utilized for mandibular (lower) overdentures is D6111.
Some clinicians prefer to incorporate a cast or 3D printed metal or milled polymer framework into an overdenture. For more information on the technical details and clinical decision evaluating framework or no framework, I encourage you to read this article. The code utilized for incorporating a framework into the prosthesis is D5876. This code is typically utilized at the same time as the D6110/D6111 code.
Summary of codes that are commonly used for LOCATOR overdenture cases:
D6191 – semi-precision abutment – placement (one for each LOCATOR Abutments)
D6192 – semi-precision attachment – placement (one for each LOCATOR Removable Housing)
D6091 – replacement of replaceable part of semi-precision or precision attachment, per attachment
D5876 – add metal substructure to acrylic full denture (per arch)
D6110 – implant/abutment supported removable denture for edentulous arch – maxillary
D6111 – implant/abutment supported removable denture for edentulous arch – mandibular
I hope this helps! If any questions, feel free and reach out to the Zest team at (800) 262-2310 or connect with the customer service team at Zest at the following link: https://www.zestdent.com/our-company-contact-us
*Disclaimer: ADA-CDT Codes and billing practices are at the discretion of the clinician and Zest Dental Solutions assumes no responsibility for the use the information contained in this document/article. Zest Dental Solutions recommends consulting with your insurance agent and/or state/regional/national insurance board should any questions arise.
——————————————————————————————————————————————-
Interested in learning more or going through more detailed examples? Zest has a comprehensive 1hr CE course on CDT coding available at our online ZestAcademy portal here https://zestacademy.teachable.com
Make sure you check out our Zest Masters Certification course – incredible CE opportunity that includes the following:
- In-person, 2-day instruction and hands-on learning from world-class clinicians.
- 33 CE Credits (includes 10 on-demand training sessions with a minimum of 16 hrs. of required & bonus materials sessions).
- Access to on-demand, online prerequisite courses.
- Over $3000 of usable and hands-on products.
- Learn how to easily transform your practice into a FIXED, full-arch powerhouse using the one and only LOCATOR system.
- A fun-filled dinner – “event” in the heart of Las Vegas!
- A one-of-a-kind experience complete with new friends and the camaraderie that only ZestMasters can provide!