I need a code for a ponic only on a maryland bridge

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Pt never developed #7. When she was a teenager a maryland bridge was make the pontic is an old metal that is attached to a porc maryland retainer. pt fractured only #7 and to be conservative, we only replaced #7. A crown was fabricated to attach to a metal wing pontic. Insurance denies every code in send including D6999 and will not help at all with a correct code. Please advise on this and if you need more explanation, please contact.

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Asked on October 18, 2022
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d6240

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Answered on October 21, 2022
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Per the ADA coding companion, you would code D6545 for the retainer tooth and D6242 for the pontic. Any D-999 codes are typically NCB and depending on your contract may also not be billable to the patient. These 999 codes should also be used as a last resort and cannot be used for additional lab fees either.

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Answered on October 19, 2022

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