D6115 Dental Code: Lower Fixed Implant Denture Billing Guide

What D6115 covers

D6115 reports the definitive full-arch prosthesis fixed to implants or implant abutments on a fully edentulous lower jaw. Practices call it an All-on-X, a screw-retained hybrid, or a fixed full-arch bridge. The patient cannot take it out; removing it means unseating prosthetic screws in the operatory. It is usually delivered months after surgery, on its own date of service.

The code is reported per arch. A patient with fixed hybrids top and bottom is one D6114 for the maxilla and one D6115 for the mandible, not a single line for the mouth and not a line per implant.

It does not report:

• The removable overdenture on the same fully edentulous lower arch. That is D6111.
• The fixed prosthesis on a lower arch that still has natural teeth. That is D6117.
• The interim fixed denture worn during healing. That is D6118 for the mandible (see the callout below).
• Surgical placement of the implant bodies, which is D6010 per implant, or second-stage surgery, which is D6011. Bill each on its own date.
• The abutments, which are D6056 prefabricated or D6057 custom fabricated.
• A connecting bar, D6055. Delta Dental of Kansas instructs that it be reported with the removable codes D6110 and D6111, not with D6114 or D6115, so confirm the carrier’s position before adding a bar to a fixed-hybrid claim.
• The maintenance visits after delivery, which run on D6080 and D6180.

The eight-code grid: three questions, one code

D6110 through D6117 form a 2x2x2 grid, and three questions place any case in one cell. Miscoding almost always comes from answering only two of them.

	Maxillary	Mandibular
Removable, edentulous	D6110	D6111
Removable, partially edentulous	D6112	D6113
Fixed, edentulous	D6114	D6115
Fixed, partially edentulous	D6116	D6117

Fixed or removable? Fixed means only the clinician removes it. Removable means the patient does, at home, which makes it D6111 no matter how many implants carry it. Carriers audit this axis hardest, because the fee gap between a fixed hybrid and a snap-in overdenture is large.

Edentulous or partially edentulous? Fully edentulous means no natural teeth remain on the arch when the prosthesis is seated. If teeth remain under or beside the prosthesis, the code is D6117.

Maxillary or mandibular? D6115 is the lower arch. Its upper twin is D6114.

D6115 or a bridge built from retainers and pontics

Both restorations are fixed to implants, so the fixed-versus-removable question does not separate them. What separates them is what the lab fabricated.

D6115 reports a denture-style prosthesis: prosthetic teeth on one framework spanning the arch, on a single line for the whole mandible. A conventional implant-supported bridge is coded by component instead, with the fee built per unit:

• Retainers. Each implant carrying the span takes a retainer code, chosen by material and by whether it seats on the implant or an abutment: D6075 for an implant-supported ceramic retainer, D6076 and D6077 for the porcelain-fused-to-high-noble and high-noble metal versions, and D6068 through D6074 for the abutment-supported equivalents.
• Pontics. Each replaced tooth takes a pontic code, such as D6245 for porcelain and ceramic, with material siblings across the D62xx range.

Do not report both routes for the same arch: D6115 alongside implant retainers for the same mandible reads as one prosthesis billed twice. Reviewers also compare the component route’s unit count against the implant sites on the surgical claims. Which route a carrier expects on a full-arch case is plan-dependent, so if the plan could be described either way, settle it in the predetermination.

Coverage and how carriers treat it

Full-arch fixed prosthetics are the category most likely to be excluded outright. Record the implant benefit, missing-tooth clause, and replacement interval on the carrier record so they are visible at treatment planning.

Categorical exclusions. Without an implant benefit, D6115 denies with the surgical codes and no appeal reverses the exclusion. The patient needs that answer before the implants go in.

Replacement intervals. Delta Dental of Kansas publishes D6114 and D6115 at once every 5 years or per contract. Northeast Delta Dental’s standard processing policy, effective January 1, 2025, covers it once every seven years for patients age 16 and above. Verify the interval on the specific contract and check the patient’s history for a prior full-arch prosthesis on the same arch.

The missing-tooth clause. Plans that cover implants often exclude an arch that was edentulous before the policy started. The carrier wants evidence the teeth were lost during coverage: extraction dates and prior radiographs.

Alternate benefit. The basis differs even within one brand. Delta Dental Insurance Company’s implant claim guidance pays an allowance toward implant-supported prosthodontics based on the fee for a standard pontic procedure. Delta Dental of North Carolina pays toward the removable appliance that would have restored the arch, which on an edentulous mandible is a complete lower denture (D5120). Neither is a denial, but the two allowances are different numbers, so read the specific entity’s exceptions-and-reductions language before building the estimate.

Interim prostheses. Delta Dental of Kansas lists D6118 and D6119 as generally not a benefit, and lists D5875, the modification of an existing denture after implant surgery, the same way.

Predetermination. Delta Dental of Kansas states that All-on-4 cases are complicated enough to warrant a predetermination request. On a case this size it is what makes the patient estimate defensible. File the response with the case so whoever builds the delivery claim months later can find it.

Documentation that supports the claim

The record should answer the three grid questions and the missing-tooth question directly:

• The arch and its edentulous status, stated as a fully edentulous mandible.
• That the prosthesis is fixed, and how it is retained. One sentence saying the patient cannot remove it separates D6115 from D6111.
• The implants supporting the arch, by site, tying the prosthesis to the surgical claims on file.
• Post-operative radiographs. Delta Dental’s implant claim guidance requires post-operative films that show the entire implant before benefits are determined, so the imaging behind the surgical claims also supports this one.
• Extraction dates for the arch, for a missing-tooth-clause review.
• The delivery date, distinct from the interim placement date, so the two prostheses are not read as one procedure.

For how the arch, tooth numbers, and remarks are entered on the claim, see the ADA dental claim form guide.

Maintenance after the case closes

A fixed hybrid generates maintenance claims for as long as the patient has it, and those codes have their own coverage answer:

• D6080 is the per-arch maintenance visit where the full-arch fixed prosthesis is unscrewed and removed, the prosthesis and abutments are cleaned and inspected, and the prosthesis is reinserted. It matches a D6115 restoration directly and received an editorial revision for CDT 2026.
• D6180, added for CDT 2025, is the same cleaning with the prosthesis left in the mouth. Removal is the only difference, and many plans apply a shared frequency to the two.
• D6197 reports replacing the restorative material that closes a screw access channel, per implant, which comes up routinely on screw-retained hybrids.

Implant maintenance is often uncovered even when the prosthesis was paid, so quote these visits as likely patient responsibility until the plan says otherwise.