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ADA Insurance Codes for Laboratory Procedures:
CROWN & BRIDGE
Inlay/Onlay Restorations
D2510
Inlay - metallic - one surface
D2520
Inlay - metallic - two surfaces
D2530
Inlay - metallic - three or more surfaces
D2542
Onlay - metallic - two surface
D2543
Onlay - metallic - three surfaces
D2544
Onlay - metallic - four or more surfaces
CROWN & BRIDGE
Porcelain, Ceramic Inlays/Onlays (include all indirect ceramic and porcelain type inlays/onlays)
D2610
Inlay - porcelain/ceramic - one surface
D2620
Inlay - porcelain/ceramic - two surfaces
D2630
Inlay - porcelain/ceramic - three or more surfaces
D2642
Onlay - porcelain/ceramic - two surface
D2643
Onlay - porcelain/ceramic - three surfaces
D2644
Onlay - porcelain/ceramic - four or more surfaces
CROWN & BRIDGE
Resin-Based Composite Inlays/Onlays Must Utilize Indirect Technique
D2650
Inlay - resin-based composite - one surface
D2651
Inlay - resin-based composite - two surfaces
D2652
Inlay - resin-based composite - three or more surfaces
D2662
Onlay - resin-based composite - two surface
D2663
Onlay - resin-based composite - three surfaces
D2664
Onlay - resin-based composite - four or more surfaces
CROWN & BRIDGE
Crowns - Single restorations only
D2710
Crown - resin (indirect) - Refers to any resin-based composite crown that is indirectly fabricated. All fiber, porcelain or ceramic reinforced polymer materials/systems are considered resin-based composites. Unfilled or non-reinforced resin crowns should be reported using D2999
D2720
Crown - resin with high noble metal
D2721
Crown - resin with predominantly base metal
D2722
Crown - resin with noble metal
D2740
Crown - porcelain / ceramic substrate
D2750
Crown - porcelain fused to high noble metal
D2751
Crown - porcelain fused to predominantly base metal
D2752
Crown - porcelain fused to noble metal
D2780
Crown - ¾ cast high noble metal
D2781
Crown - ¾ cast predominantly base metal
D2782
Crown - ¾ cast noble metal
D2783
Crown - ¾ porcelain/ceramic - This code does not include facial veneers
D2790
Crown - full cast high noble metal
D2791
Crown - full cast predominantly base metal
D2792
Crown - full cast noble metal
D2799
Provisional crown
D2952
Cast post and core in addition to crown - Cast post and core is separate from crown
D2953
Each additional cast post - same tooth - To be used with D2952
D2961
Labial veneer (resin laminate) - laboratory - Refers to labial/facial indirect resin bonded veneers
D2962
Labial veneer (porcelain laminate) - laboratory - Refers to facial veneers that extend interproximally and/or cover the incisal edge. Porcelain/ceramic veneers presently include all ceramic and porcelain veneers
D2980
Crown repair, by report - Includes removal of crown, if necessary. Describe procedure.
D2999
Unspecified restorative procedure, by report.
CROWN & BRIDGE
Fixed Partial Denture Pontics
D6210
Pontic - cast high noble metal
D6211
Pontic - cast predominantly base metal
D6212
Pontic - cast noble metal
D6240
Pontic - porcelain fused to high noble metal
D6241
Pontic - porcelain fused to predominantly base metal
D6242
Pontic - porcelain fused to noble metal
D6245
Pontic - porcelain/ceramic
D6250
Pontic - resin with high noble metal
D6251
Pontic - resin with predominantly base metal
D6252
Pontic - resin with noble metal
D6253
Provisional pontic - Pontic utilized as an interim of at least six months duration during restorative treatment to allow adequate time for healing or completion of other procedures. This is not to be used as a temporary pontic for routine prosthetic fixed partial dentures.
CROWN & BRIDGE
Fixed Partial Denture Retainers - Inlays / Onlays
D6545
Retainer - cast metal for resin bonded fixed prosthesis
D6548
Retainer - porcelain/ceramic for resin bonded fixed prosthesis
D6600
Inlay - porcelain/ceramic, two surfaces
D6601
Inlay - porcelain/ceramic, three or more surfaces
D6602
Inlay - cast high noble metal, two surfaces
D6603
Inlay - cast high noble metal, three or more surfaces
D6604
Inlay - cast predominantly base metal, two surfaces
D6605
Inlay - cast predominantly base metal, three or more surfaces
D6606
Inlay - cast noble metal, two surfaces
D6607
Inlay - cast noble metal, three or more surfaces
D6608
Onlay - porcelain/ceramic, two surfaces
D6609
Onlay - porcelain/ceramic, three or more surfaces
D6610
Onlay - cast high noble metal, two surfaces
D6611
Onlay - cast high noble metal, three or more surfaces
D6612
Onlay - cast predominantly base metal, two surfaces
D6613
Onlay - cast predominantly base metal, three or more surfaces
D6614
Onlay - cast noble metal, two surfaces
D6615
Onlay - cast noble metal, three or more surfaces
CROWN & BRIDGE
Fixed Partial Denture Retainers - Crowns
D6720
Crown - resin with high noble metal
D6721
Crown - resin with predominantly base metal
D6722
Crown - resin with noble metal
D6740
Crown - porcelain/ceramic
D6750
Crown - porcelain fused to high noble metal
D6751
Crown - porcelain fused to predominantly base metal
D6752
Crown - porcelain fused to noble metal
D6780
Crown - ¾ cast high noble metal
D6781
Crown - ¾ cast predominantly base metal
D6782
Crown - ¾ cast noble metal
D6783
Crown - ¾ porcelain/ceramic
D6790
Crown - full cast high noble metal
D6791
Crown - full cast predominantly base metal
D6792
Crown - full cast noble metal
D6793
Provisional retainer crown - Retainer crown utilized as an interim of at least six months duration during restorative treatment to allow adequate time for healing or completion of other procedures. This is not to be used as a temporary retainer crown for routine prosthetic fixed partial dentures.
CROWN & BRIDGE
Other Fixed Partial Denture Services
D6920
Connector bar - A device attached to fixed partial denture retainer or coping which serves to stabilize and anchor a removable overdenture prosthesis.
D6930
Re-cement fixed partial denture
D6940
Stress breaker - A non-rigid connector.
D6950
Precision attachment - Report attachment separately from crown; a male and female pair constitutes one precision attachment. Describe type of attachment used.
D6970
Cast post and core in addition to fixed partial denture retainer
D6971
Cast post as part of fixed partial denture retainer
D6972
Prefabricated post and core in addition to fixed partial denture retainer
D6973
Core build up for retainer, including any pins
D6975
Coping - metal - To be used as a definitive restoration
D6976
Each additional cast post - same tooth - To be used with D6970 or D6971
D6977
Each additional prefabricated post - same tooth - To be used with D6972
D6980
Fixed partial denture repair, by report
D6985
Pediatric partial denture, fixed - This prosthesis is used primarily for aesthetic purposes.
D6999
Unspecified fixed prosthodontic procedure, by report - Used for procedure that is not adequately described by a code. Describe procedure.
REMOVABLE PROSTHETICS
Complete Dentures (Including Routine Post-Delivery Care)
D5110
Complete denture - maxillary
D5120
Complete denture - mandibular
D5130
Immediate denture - maxillary - Includes limited follow-up care only; does not include required future rebasing/relining procedure(s) or a complete new denture.
D5140
Immediate denture - mandibular - Includes limited follow-up care only; does not include required future rebasing/relining procedure(s) or a complete new denture.
REMOVABLE PROSTHETICS
Partial Dentures (Including Routine Post-Delivery Care)
D5211
Maxillary partial denture - resin base (including any conventional clasps, rests and teeth) - Includes acrylic resin base denture with resin or wrought- wire clasps.
D5212
Mandibular partial denture - resin base (including any conventional clasps, rests and teeth) - Includes acrylic resin base denture with resin or wrought - wire clasps.
D5213
Maxillary partial denture - cast metal framework with resin denture bases (including any conventional clasps, rests and teeth)
D5214
Mandibular partial denture - cast metal framework with resin denture bases (including any conventional clasps, rests and teeth)
D5281
Removable unilateral partial denture - one piece cast metal (including clasps and teeth)
REMOVABLE PROSTHETICS
Adjustments to Dentures
D5410
Adjust complete denture - maxillary
D5411
Adjust complete denture - mandibular
D5421
Adjust partial denture - maxillary
D5422
Adjust partial denture - mandibular
REMOVABLE PROSTHETICS
Repairs to Complete Dentures
D5510
Repair broken complete denture base
D5520
Repair missing or broken teeth - complete denture (each tooth)
REMOVABLE PROSTHETICS
Repairs to Partial Dentures
D5610
Repair resin denture base
D5620
Repair cast framework
D5630
Repair or replace broken clasp
D5640
Replace broken teeth - per tooth
D5650
Add tooth to existing partial denture
D5660
Add clasp to existing partial denture
D5670
Replace all teeth and acrylic on cast metal framework (maxillary)
D5671
Replace all teeth and acrylic on cast metal framework (mandibular)
REMOVABLE PROSTHETICS
Denture Rebase Procedures
Rebase - process of refitting a denture by replacing the base material.
D5710
Rebase complete maxillary denture
D5711
Rebase complete mandibular denture
D5720
Rebase maxillary partial denture
D5721
Rebase mandibular partial denture
REMOVABLE PROSTHETICS
Denture Reline Procedures
Reline is the process of resurfacing the tissue side of a denture with new base material.
D5730
Reline complete maxillary denture (chair side)
D5731
Reline complete mandibular denture (chair side)
D5740
Reline maxillary partial denture (chair side)
D5741
Reline mandibular partial denture (chair side)
D5750
Reline complete maxillary denture (laboratory)
D5751
Reline complete mandibular denture (laboratory)
D5760
Reline maxillary partial denture (laboratory)
D5761
Reline mandibular partial denture (laboratory)
REMOVABLE PROSTHETICS
Interim Prosthesis
A provisional prosthesis designed for use over a limited period of time, after which it is to be replaced by a more definitive restoration.
D5810
Interim complete denture (maxillary)
D5811
Interim complete denture (mandibular)
D5820
Interim partial denture (maxillary) - Includes any necessary clasps and rests.
D5821
Interim partial denture (mandibular) - Includes any necessary clasps and rests.
REMOVABLE PROSTHETICS
Other Removable Prosthetic Services
D5850
Tissue conditioning, maxillary - Treatment reline using materials designed to heal unhealthy ridges prior to more definitive final restoration.
D5851
Tissue conditioning, mandibular - Treatment reline using materials designed to heal unhealthy ridges prior to more definitive final restoration.
D5860
Over denture - complete, by report - Describe and document procedures as performed. Other separate procedures may be required concurrent to D5860.
D5861
Over denture - partial, by report - Describe and document procedures as performed. Other separate procedures may be required concurrent to D5861.
D5862
Precision attachment, by report - Each set of male and female components should be reported as one precision attachment. Describe the type of attachment used.
D5867
Replacement of replaceable part of semi-precision or precision attachment (male or female component)
D5875
Modification of removable prosthesis following implant surgery - The modification of existing removable prosthesis is sometimes necessary at the time of implant placement and bone graft surgery and is always necessary at the time of the placement of the healing caps. This code could also be used to report the modification of an existing prosthesis when the abutments are placed and retentive elements are placed into the removable prosthesis, thereby reducing the need for a new prosthesis.
D5899
Unspecified removable prosthodontic procedure, by report - Use for a procedure that is not adequately described by a code. Describe procedure.
REMOVABLE PROSTHETICS
Miscellaneous Services
D9940
Occlusal guard, by report - Removable dental appliances, which are designed to minimize the effects of bruxism (grinding) and other occlusal factors.
D9941
Fabrication of athletic mouthguard
ADA Insurance Codes for Dental Implants
IMPLANTS
Implant Services
D6010
Surgical placement of implant body: endosteal implant - Includes second stage surgery and placement of healing cap.
D6020
Abutment placement or substitution: endosteal implant - An abutment is placed to permit fabrication of a dental prosthesis. This procedure may include the removal of a temporary healing cap or replacement with an abutment of alternate design. The intention of this code is to report this procedure by other than the dentist who placed the implant.
D6040
Surgical placement: eposteal implant - An eposteal (subperiosteal) framework of a bio-compatible material designed and fabricated to fit on the surface of the bone of the mandible or maxilla with perimucosal extensions which provide support and attachment of a prosthesis. This may be a complete arch or unilateral appliance. Eposteal implants rest upon the bone and under the periosteum.
D6050
Surgical placement: transosteal implant - A transosteal (transosseous) bio-compatible device with threaded posts penetrating both the superior and inferior cortical bone plates of the mandibular sympysis and exiting through the perimucosa providing support and attachment for a dental prosthesis. Transcosteal implants are placed completely through the bone and into the oral cavity from extraoral or intraoral.
IMPLANTS
Implant Supported Prosthetics
D6053
Implant/abutment supported removable denture for completely edentulous arch
D6054
Implant/abutment supported removable denture for partially edentulous arch
D6055
Dental implant supported connecting bar - A device attached to transmucosal abutments to stabilize and anchor a removable overdenture prosthesis.
D6056
Prefabricated abutment - A connection to an implant that is a manufactured component usually made of machined high noble metal, titanium, titanium alloy or ceramic. Modification of a prefabricated abutment may be necessary, and is accomplished by altering its shape using dental burs/diamonds.
D6057
Custom abutment - A connection to an implant that is a fabricated component, usually by a laboratory, specific for an individual application. A custom abutment is typically fabricated using a casting process and usually is made of noble or high noble metal. A "UCLA" abutment is an example of this type abutment.
D6058
Abutment supported porcelain/ceramic crown - A single crown restoration that is retained, supported and stabilized by an abutment on an implant; may be screw retained or cemented.
D6059
Abutment supported porcelain fused to metal crown (high noble metal) - A single metal-ceramic crown restoration that is retained, supported and stabilized by an abutment on an implant; may be screw retained or cemented.
D6060
Abutment supported porcelain fused to metal crown (predominantly base metal) - A single metal-ceramic crown restoration that is retained, supported and stabilized by an abutment on an implant; may screw retained or cemented.
D6061
Abutment supported porcelain fused to metal crown (noble metal) - A single metal-ceramic crown restoration that is retained, supported and stabilized by an abutment on an implant; may be screw retained or cemented.
D6062
Abutment supported cast metal crown (high noble metal) - A single cast metal crown restoration that is retained, supported and stabilized by an abutment on an implant; may be screw retained or cemented.
D6063
Abutment supported cast metal crown (predominantly base metal) - A single cast metal crown restoration that is retained, supported, and stabilized by an abutment on an implant; may be screw retained or cemented.
D6064
Abutment supported cast metal crown (noble metal) - A single cast metal crown restoration that is retained, supported, and stabilized by an abutment on an implant; may be screw retained or cemented.
D6065
Implant supported porcelain/ceramic crown - A single crown restoration that is retained, supported, and stabilized by an implant; may be screw retained or cemented.
D6066
Implant supported porcelain fused to metal crown (titanium, titanium alloy, high noble metal) - A single metal-ceramic crown restoration that is retained,supported, and stabilized by an implant; may be screw retained or cemented.
D6067
Implant supported metal crown (titanium, titanium alloy, high noble metal) - A single cast metal crown restoration that is retained, supported and stabilized by an abutment on an implant; may be screw retained or cemented.
D6068
Abutment supported retainer for porcelain/ceramic FPD - A ceramic retainer for a fixed partial denture that gains retention, support and stability from an abutment on an implant; may be screw retained or cemented.
D6069
Abutment supported retainer for porcelain fused to metal FPD (high noble metal) - A metal-ceramic retainer for a fixed partial denture that gains retention, support and stability from an abutment on an implant; may be screw retained or cemented.
D6070
Abutment supported retainer for porcelain fused to metal FPD (predominantly base metal) - A metal-ceramic retainer for a fixed partial denture that gains retention, support and stability from an abutment on an implant; may be screw retained or cemented.
D6071
Abutment supported retainer for porcelain fused to metal FPD (noble metal) - A metal-ceramic retainer for a fixed partial denture that gains retention, support and stability from an abutment on an implant; may be screw retained or cemented.
D6072
Abutment supported retainer for cast metal FPD (high noble metal) - A cast metal retainer for a fixed partial denture that gains retention, support and stability from an abutment on an implant; may be screw retained or cemented.
D6073
Abutment supported retainer for cast metal FPD (predominantly base metal) - A cast metal retainer for a fixed partial denture that gains retention, support and stability from an abutment on an implant; may be screw retained or cemented.
D6074
Abutment supported retainer for cast metal FPD (noble metal) - A cast metal retainer for afixedpartialdenturethatgainsretentionsupportandstabilityfromanabutmentonan
implant; may be screw retained or cemented.
D6075
Implant supported retainer for ceramic FPD - A ceramic retainer for a fixed partial denture that gains retention, support and stability from an implant; may be screw retained or cemented.
D6076
Implant supported retainer for porcelain fused to metal FPD (titanium, titanium alloy, or high noble metal) - A metal-ceramic retainer for a fixed partial denture that gains retention, support and stability from an implant; may be screw retained or cemented.
D6077
Implant supported retainer for cast metal FPD (titanium, titanium alloy, or high noble metal) - A cast metal retainer for a fixed partial denture that gains retention, support and stability from an implant; may be screw retained or cemented.
D6078
Implant/abutment supported fixed denture for completely edentulous arch - A prosthesis that is retained, supported and stabilized by implants or abutments placed on implants, but does not have specific relationships between implant positions and replacement teeth; may be screw retained or cemented; commonly referred to as a "hybrid prosthesis."
D6079
Implant/abutment supported fixed denture for partially edentulous arch - A prosthesis that is retained, supported and stabilized by implants or abutments placed on implants, but does not have specific relationships between implant positions and replacement teeth; may be screw retained or cemented; commonly referred to as a "hybrid prosthesis."
Implant maintenance procedures, including removal of prosthesis, cleansing of prosthesis and abutments and reinsertion of prosthesis - This procedure includes a prophylaxis to provide active debriding of the implant and examination of all aspects of the implant system, including the occlusion and stability of the superstructure. The patient is also instructed in thorough daily cleansing of the implant.
D6090
Repair implant supported prosthesis, by report - This procedure involves the repair or replacement of any part of the implant supported prosthesis.
D6095
Repair implant abutment, by report - This procedure involves the repair or replacement of any part of the implant abutment.
D6100
Implant removal, by report - This procedure involves the surgical removal of an implant. Describe procedure.
D6199
Unspecified implant procedure, by report - Use for procedure that is not adequately described by a code. Describe procedure.
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