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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


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.


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

Administrative guidelines

No benefit.



CDT - D5000-D6999 - see above


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