Delta Dental Implant Claims How to Avoid Denials Improve Coding
January 5, 2026
Dental implants have become an increasingly popular tooth restoration option due to their durability and natural appearance. However, both patients and dental clinics frequently encounter challenges when filing insurance claims for implant procedures with Delta Dental, one of America's leading dental insurers. Understanding the nuances of Delta Dental's coverage policies can help streamline the claims process and ensure proper reimbursement.
While most Delta Dental plans don't include implants as standard coverage, this doesn't mean all implant-related claims will be denied. Many rejections stem from coding errors rather than lack of coverage. Proper coding is essential for successful claims processing.
The abutment, which connects the implant to the crown, requires specific coding based on its type:
- D6056: Prefabricated abutment - includes modification and placement
- D6057: Custom abutment - includes placement
Prefabricated abutments are mass-produced and may require adjustments, while custom abutments are laboratory-made for individual patients.
Crowns are categorized by their attachment method, each with distinct coding requirements:
- Abutment-supported crowns: Use either D6056 or D6057 codes and must include the corresponding abutment code when filing claims
- Implant-supported crowns: Attach directly to the implant without an abutment (code D6065) and shouldn't include abutment codes
A common error occurs when offices submit abutment codes (D6057) for implant-supported crowns (D6065), resulting in denials. The proper submission for abutment-supported crowns would be:
- D6058 for the crown
- D6057 for the custom abutment
- 161: Insufficient or conflicting information
- 7C2: Missing or conflicting related services
- 9WA: Service considered part of completed procedure
Implant crowns are further classified by restoration type:
- Single implant crowns: Restore individual implants
- Fixed bridge implant crowns: Serve as anchors for bridges replacing multiple teeth
Incorrectly coding bridge abutments as single crowns (D6065) will trigger denials. The proper coding for bridge abutments is D6075.
Even when implants aren't covered, Delta Dental typically provides alternative benefits based on standard bridge costs. Patients are responsible for the difference between implant and bridge expenses.
- FLM: Alternative benefit applied
- 503: Service not covered under plan
Implant placement for congenitally missing permanent teeth generally isn't covered, nor are space corrections due to developmental anomalies.
- 511: Not covered for congenital/developmental corrections
Both pre-operative and post-operative X-rays showing the entire implant are mandatory for claim approval.
Use D6092 (single crown) or D6093 (bridge) for implant crown recementation instead of natural tooth codes.
Complete arch restoration typically uses 4-6 implants.
When included in implant coverage, this is considered part of the procedure cost and shouldn't be billed separately.
This is included in the initial implant placement (D6010) and shouldn't be billed separately.
Requires detailed narrative reports as tools/components are considered part of the procedure.
Successful implant claims with Delta Dental require precise coding, complete documentation including radiographs, and clear communication. While policies serve as guidelines, providing thorough case details can help resolve unique situations. With proper preparation, both practices and patients can navigate the claims process more effectively.