D6096Remove Broken Implant Retaining Screw

What This Code Covers

D6096 covers remove broken implant retaining screw. The specified implant component is removed. Documentation should include the reason for removal and any planned replacement.

Billing Guide

Bill this code when:

• The implant procedure described by D6096 is performed
• Documentation includes implant system, size, and placement details
• The specific prosthetic component and material match the code description

Do not bill this code when:

• The implant component or material type does not match this code
• The procedure is already included in another code being billed
• The prosthesis is removable when this code specifies fixed, or vice versa
• The procedure is better described by D6076 (Implant supported retainer for porcelain fused to ...)

Insurance and Denial Prevention

Key Payer Rules:

• Fixed prosthodontic procedures are typically covered as major services
• Implant coverage varies widely by plan. Many plans exclude implants entirely
• Material downgrades may apply (high noble to base metal)
• Prior authorization is commonly required for implant and bridge procedures

Common Denials and How to Respond:

• Implants not covered - Check if the medical plan covers implants when the dental plan does not. Submit a detailed treatment narrative.
• Material downgrade - Bill the actual material placed and inform the patient of any balance due to plan downgrades.
• Missing tooth clause - Some plans exclude replacement of teeth that were missing before the plan effective date. Verify plan terms.