by Michael Scherer, DMD, MS, FACP, DABOI/ID
One of the most popular questions I get a CE courses is… what CDT codes should I use for my LOCATOR or LOCATOR FIXED cases!?
The American Dental Association publishes a text of CDT codes and recommends various approaches for how we code appropriately for clinical practices. Single teeth? Fairly straight forward… full-arch surgical cases and prosthetics?! It can be tricky for sure!!
What makes the system so unique is that it permits a clinician to fabricate a fixed full-arch “hybrid” style restoration simply by using a LOCATOR abutment and a snap-in housing like mechanism to firmly adhere the restoration to the abutments. So wait… it’s a LOCATOR? Yes! LOCATOR FIXED is a unique restoration that is FIXED however it’s removable by the clinician in a matter of a few seconds. Check out this video showing how it’s removed!
On top of it, the LOCATOR FIXED prosthesis can be converted from a fixed restoration to a removable restoration in a matter less than a couple of minutes. Check out this step-by-step video here on how to see it in action!
A question that I naturally get all the time from clinicians is that they seek guidance on know how to effectively use ADA/CDT Codes for LOCATOR FIXED. 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.*
Since LOCATOR FIXED is unique but also is something that can be converted back from a FIXED to Removable restoration, many of the same coding strategies that are covered in this online course applies perfectly to this strategy!
Since the LOCATOR abutment is the same abutment for both Removable and FIXED restorations – clinicians typically use D6191 as the code for abutment. This codes does not include any other parts and is for the abutment only.
A LOCATOR FIXED restoration 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 FIXED Housing (left, top) is embedded within the restoration and is a metal component that holds the LOCATOR FIXED inserts (left, bottom). Many clinicians use the D6192 as the code for the Housing, however, some clinicians may use D6199 for the Housings for LOCATOR FIXED as well since typically D6192 is primarily intended for use with removable indications. The initial use of the D6192 code typically includes the initial FIXED Inserts, however, does not include subsequent/replacement inserts.
Clinicians typically use the D6091 code for the LOCATOR FIXED inserts. Since they are one-time use only, a clinician can use the code each time the prosthesis is removed and when inserts are replaced. The code is the same as the traditional LOCATOR removable insert change so long as you are changing the insert and not the housing. When replacing the housing and insert, many clinicians use the D6192 which includes the housings & inserts.
When we start to think about the prosthetics, there is a bit of a grey area. Some advocate using D6110 / D6111, however, those are the maxillary and mandibular overdenture CDT codes. If the intention is to keep the patient in a removable prosthesis, by the clinician, that would be the code to go with. If the intention is to provide a full-arch FIXED prosthesis, the typical codes are D6114 / D6115 for the maxillary and mandibular prosthesis.
Codes that are commonly used for LOCATOR FIXED prosthetics include:
D6191 – semi-precision abutment – placement (one for each LOCATOR abutments)
D6192 – semi-precision placement (one for each LOCATOR FIXED Housing or Removable Housing)
D5876 – add metal substructure to acrylic full denture (per arch)
D6114 – Implant/abutment supported fixed denture for edentulous arch – maxillary
D6115 – Implant/abutment supported fixed 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? We have 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!