Provisional Retainer Crown

Policy No: 41A
Originally Created: 01/01/2003
Section: Prosthodontics
Last Reviewed: 01/01/2019
Last Revised: 01/01/2018
Approved: 01/01/2018
Effective: 01/01/2018

Description

Provisional Retainer Crown (D6793)
Retainer crown utilized as an interim of at least six months duration during restorative treatment to allow adequate time for healing or completion of other procedures. This is not to be used as a temporary retainer crown for routine prosthetic fixed partial dentures.

Policy/criteria

Procedures are in accordance with generally accepted standards of dental practice.

Administrative guidelines

No benefit.

Codes

CDT - D5000-D6999 - see above.

Disclaimer

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