D6115 Dental Code: Lower Fixed Implant Denture Billing Guide

What D6115 covers

D6115 reports the definitive full-arch prosthesis delivered on a fully edentulous lower jaw and fixed to implants or implant abutments. This is the restoration practices describe as an All-on-X, a screw-retained hybrid, or a fixed full-arch bridge. It stays in the mouth. The patient cannot take it out, and removing it means unseating prosthetic screws in the operatory.

The code covers the prosthesis for that arch and nothing under it. It is reported per arch, so a patient restored top and bottom with fixed hybrids 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.
• Surgical placement of the implant bodies, which is D6010 per implant, or second-stage surgery, which is D6011.
• The abutments, which are D6056 prefabricated or D6057 custom fabricated. A connecting bar has its own code, D6055, but Delta Dental of Kansas instructs that it be reported with the removable codes D6110 and D6111 rather than alongside 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 is a 2x2x2 grid, and three yes-or-no questions land any case in exactly one cell. Miscoding here 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. D6114 through D6117 are the fixed half; D6110 through D6113 are the removable half. This is the axis carriers audit 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 that arch. D6114 and D6115 are the fully edentulous fixed codes; D6116 and D6117 are the partially edentulous fixed codes.

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

Deciding which full-arch code to bill

1. Confirm the arch is fully edentulous at delivery. If the treatment plan extracted the remaining lower teeth earlier in the case, the arch is edentulous when the prosthesis is seated, and D6115 is what the record supports. If teeth remain under or beside the prosthesis, you are in D6117.
2. Confirm the prosthesis is fixed. Screw-retained or cemented, removed only in the operatory. If the patient snaps it out at home, it is D6111 regardless of how many implants carry it.
3. Separate the interim from the definitive. The prosthesis delivered the day of surgery is D6118 on the lower arch. D6115 is the definitive restoration, usually months later, and it goes on its own date of service.
4. Bill the components on their own dates. D6010 per implant at placement, D6011 at second stage, the abutment codes when abutments are seated. D6115 is the delivery line only. If the case uses a connecting bar, check whether the carrier accepts D6055 on a fixed-hybrid arch at all, since Delta Dental of Kansas pairs that code with the removable overdenture codes instead.
5. Set the maintenance expectation now. A fixed hybrid generates recurring maintenance claims for as long as the patient has it. Decide at delivery how those get coded and quoted.

D6115 or a bridge built from retainers and pontics

Both restorations screw or cement to implants and neither comes out at home, so the fixed-versus-removable question does not separate them. The line between them is what the lab fabricated, and therefore how the arch is reported.

D6115 reports a denture-style prosthesis: prosthetic teeth carried on one framework spanning the arch, delivered on a single line for the whole mandible. A conventional implant-supported fixed bridge is component-coded instead. Each implant carrying the span takes its own retainer code, selected by material and by whether the retainer seats on the implant or on an abutment: D6075 for an implant-supported ceramic retainer, D6076 and D6077 for the porcelain-fused-to-high-noble and high-noble metal versions, D6068 through D6074 for the abutment-supported equivalents. Each replaced tooth in the span takes a pontic code, D6245 for porcelain and ceramic with material siblings across the D62xx range. The fee builds per unit rather than per arch.

Two things follow. Do not report both routes for the same arch: a claim carrying D6115 alongside a set of implant retainers for the same mandible reads as the same prosthesis billed twice. And because the component route produces a unit count, reviewers compare that count against the implant sites already on the surgical claims. Which route a carrier expects on a full-arch case is plan-dependent, so if the treatment plan could be described either way, the predetermination is where to settle it.

Coverage and how carriers treat it

Full-arch fixed prosthetics are the category most likely to be excluded outright, so verification is not a formality here.

Many plans exclude implant services categorically. When there is no implant benefit, D6115 denies alongside the surgical codes and there is no appeal that reverses a plan exclusion. That answer needs to reach the patient before the implants go in, not at the delivery appointment.

Replacement intervals are long and plan-specific. Delta Dental of Kansas publishes D6114 and D6115 at once every 5 years or per contract. Northeast Delta Dental’s standard processing policy runs longer, a covered benefit once every seven years for patients age 16 and above, effective January 1, 2025. Two member companies of the same brand, two intervals, so verify the interval against the specific contract and check the patient’s prosthetic history for a prior full-arch prosthesis on the same arch.

The missing-tooth clause is the common trap. Plans that do cover implants frequently exclude an arch that was already edentulous before the policy started. The carrier is looking for evidence the teeth were lost while the patient was covered, which means extraction dates and prior radiographs.

Alternate benefit, and the basis is not consistent even inside one brand. Delta Dental Insurance Company’s implant claim guidance says its standard plans pay an allowance toward implant-supported prosthodontics based on the fee for a standard pontic procedure. Delta Dental of North Carolina, by contrast, publishes the conventional-prosthesis basis, paying toward what the removable appliance that would have restored the arch costs, which on an edentulous mandible is a complete lower denture (D5120). Two member companies of the same brand, two different calculations, and neither is a denial. Read the specific entity’s exceptions-and-reductions language before you build the estimate, because a pontic-fee allowance and a complete-denture allowance are not the same number.

Interim prostheses are often not covered. 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 is the practical answer to all of this. Delta Dental of Kansas says plainly that All-on-4 cases are complicated enough to warrant a predetermination request, and on a case this size it is what turns a treatment plan into a defensible patient estimate.

Documentation that supports the claim

The record should answer the three grid questions and the missing-tooth question without the reviewer having to infer anything:

• 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 is the line that separates D6115 from D6111.
• The implants supporting the arch, by site, tying the prosthesis back to the surgical claims already on file.
• Post-operative radiographs. Delta Dental’s implant claim guidance requires post-operative films of implant placement that depict the entire implant before benefits are determined on a paid claim, so the imaging behind the surgical claims also supports the prosthetic one.
• Extraction dates for the arch, which is what a missing-tooth-clause review turns on.
• The delivery date, distinct from the interim placement date, so the two prostheses are not read as one procedure.

Maintenance after the case closes

A fixed hybrid does not stop generating claims at delivery, and the maintenance codes are a separate family with 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 is the code that matches a D6115 restoration directly, and it received an editorial revision for CDT 2026.
• D6180 is the same prosthesis cleaned while it stays in the mouth. It joined the code set for CDT 2025. Removal versus no removal is the only thing that separates the two, and many plans run them against a shared frequency allowance.
• 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 frequently uncovered even when the prosthesis itself was paid, so quote those visits as likely patient responsibility until the plan says otherwise.

What to get right in your PMS

1. Load all eight grid codes with labels, not just numbers. Label each of D6110 through D6117 by fixed-versus-removable, edentulous-versus-partial, and arch. A pick list that reads “implant denture” eight times guarantees the wrong cell eventually.
2. Load D6118 and D6119 separately and label the arch. These are the two most-transposed codes in the family. Spell out mandibular and maxillary in the description so nobody reasons from the number.
3. Track the case as a sequence, not a visit. D6010 and D6011 at surgery, the abutment codes at their own visit, D6118 for the interim, D6115 at delivery. Each on its own date, each on its own claim.
4. Flag the implant benefit and replacement interval on the carrier record. Implant exclusions, missing-tooth clauses, and 5-to-7-year replacement clauses all need to be visible at treatment planning, not discovered on the EOB.
5. File the predetermination with the case. When the carrier’s response comes back it should live where the person building the delivery claim months later will find it.

For how the arch, the tooth numbers, and the remarks field are filled in on the claim itself, see the ADA dental claim form guide.