• Surgical placement of the implant post (body or fixture)
• Placement of the connecting components (when needed)
• Final prosthetic restoration (either single crowns, bridges or dentures)

Let’s talk about a basic implant:

A typical implant has 2-3 components:  Implant, abutment & restoration

Implant Post/Body/Fixture that is placed in the bone.
(the two most common types are endosteal and mini implants)

CDT Codes for the surgical placement of an implant body

• (D6010) Endosteal Implant:  Placement of full-sized implant fixture into the jawbone
• (D6013) Mini Implant :  Placement of mini implant fixture into the jawbone

Abutment “connecting element” to which the final restoration is attached
(when dentist determines this is needed)

Abutments (what connects the implant to the restoration) can be either prefabricated or custom

 CDT Codes for abutments

• (D6056) Prefabricated Abutment:  A manufactured component.  The procedure includes modification and placement.

• (D6057) Custom Abutment:  Created by a lab for a specific individual, (usually if there are esthetic concerns.  The procedure includes placement.

Final Restoration (single implant crown, fixed bridge, denture etc)
There are many choices for final restoration codes, depending on how the final restoration is designed and what is actually being placed.

Single Unit Implant Crowns – Either abutment supported or implant supported. Crown CDT code is based on type of material used and type of attachment.

I think we are familiar with the type of crown materials used – but there is still confusion regarding the type of attachment system – either abutment or implant supported.  Neither is the determining factor in code selection.

Abutment supported Single Unit Crowns (D6058-D6064, D6094):  Implant crowns that are attached  to abutment(D6056 or D6057)  NOT ATTACHED DIRECTLY TO IMPLANT post (submit the applicable abutment CDT code with the applicable single unit crown  CDT code)

Implant Supported Single Unit Crowns (D6065-D6067):  Implant crowns attached directly to implant post NO ABUTMENT IS USED.

Implant Supported Fixed Bridges (implant bridges) Two types of retainer crowns: abutment supported or implant supported. Appropriate CDT code is based on type of material used and the method of attachment. Both types  are either cemented or screw retained and neither method determines what code to use.

Abutment Supported Retainer Crowns (D6068-D6074  and D6194):  Implant retainer crowns. Attached to an abutment (D6056 or D6057) NOT DIRECTLY TO IMPLANT POST. Submit with appropriate abutment code and appropriate retainer crown code.

Implant Supported Retainer Crowns(D6075-D6077):  Implant retainer crowns attached directly to the implant post.  NO ABUTMENT IS USED

Implant Supported Dentures

There are 2 types of implant or abutment supported dentures; removable or fixed(hybrid) Codes are not determined by the type of attachment system.

Denture CDT code selection is determined by two things:

• Is the denture replacing a full or partial complement of teeth?
• Will the patient be able to remove the denture by themselves – or does it require dentist/staff?

If the patient can remove the denture by themselves = Removable Implant Denture

If unable to remove without assistance of dentist/staff = Fixed Implant Denture

Implant/Abutment Supported Removable Dentures: Overdentures are supported by implants and the patient can remove them. (typically have pre-fab abutments, a connecting bar and precision/semi-precision attachment.

Codes for Removable Complete Dentures: (D6110 and D6111)
Codes for Removable Partials: (D6112 and D6113)

Implant/Abutment Supported Fixed (Hybrid) Dentures: Implant dentures a patient cannot remove. Either screwed in directly to  implant or connected by abutments.

Codes for Fixed Complete Dentures (D6114 and D 6115)
Codes for Fixed Partials (D6116 and D6117)

Overdenture:

• (D6052) Semi-precision Attachment Abutment:  Placement of a pre-fab abutment to the full sized implant post.  Includes luting of keeper assembly (male attachment) into the overdenture.
• (D6055) Implant Supported or Abutment Supported Connecting Bar:  A device to help stabilize a prosthesis.  Attaches to abutments or directly to the implants themselves to make the prosthesis more secure.  (Examples:  Hader and Dolder bar).  The entire bar is reported as a single unit but an abutment should be documented and reported as for each implant that supports the connecting bar.

Connecting bars can be designed to use other types of retentive mechanisms, i.e.: semi-precision attachments.