D6980Fixed Partial Denture Repair, by Report

What This Code Covers

D6980 covers fixed partial denture repair, by report. The damaged component of the existing fixed prosthesis is repaired. Documentation should describe the defect and repair method.

Billing Guide

Bill this code when:

• The repair described by D6980 is performed on an existing restoration or prosthesis
• The existing device is still serviceable after the repair
• Documentation describes the defect and repair method

Do not bill this code when:

• A new restoration or prosthesis is fabricated instead of repairing the existing one
• The device type does not match this code description
• The repair is included in another code being billed at the same visit
• The procedure is better described by D6970 ()

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.