Fixed Partial Denture Repair, By Report Template

Fixed partial denture repair - by report.

RMH: Medical history reviewed/updates

Bridge location: Bridge location
Units: Units
Type of repair: Type of repair
Porcelain fracture.
Connector fracture.
Abutment decementation.

Radiographs/photos: Radiographs/photos reviewed/taken and findings

Procedure:
Damage assessed.
Repair completed.
Bridge reseated.
Fit verified.
Occlusion checked.
Recemented if needed.

Patient instructions: Instructions reviewed.

If repair not possible, replacement bridge discussed.

Complications: None or describe.
Patient tolerance: Tolerance/response.

NV: Next visit

Prosthesis age/original date: Original placement/delivery date or estimated age
Repair/recement support: Reason for service and description of repair/recement performed
Replacement discussion: If replacement needed, options discussed

Documentation requirements

D6980 is a "by report" code, which means a defensible chart note must double as the narrative the carrier will read on the claim. The note (and any free-text narrative submitted with the claim) must answer four questions: what bridge (location, units, abutments, age, original placement context), what failed (type, location, and cause of damage — objective findings, not conclusions), what was done (the actual repair workflow, materials, and verification), and why repair was the right answer (vs. recementation, vs. replacement). Include:

• Medical history review and update — meds, conditions, allergies, recent hospitalizations, and any new systemic risk factors. For a bridge-bearing patient specifically, document parafunction / bruxism (load on the prosthesis and a recurrence driver), GERD or dietary acid (porcelain etch and chip risk), xerostomia and caries-risk meds (recurrent caries on the abutments is the leading cause of decementation), and anti-resorptive therapy if relevant to abutment prognosis.
• Existing prosthesis identification — bridge location (e.g., "maxillary right #3-x-5" or "mandibular anterior #22-x-x-25"), number of units, abutment teeth, pontic positions, material (PFM, full cast, all-ceramic, zirconia, layered zirconia), original delivery date and fabricating practice/lab when knowable. Age of the bridge is the highest-yield audit field on a D6980 note — it drives the carrier's repair-vs-replace logic and the warranty exclusion check (most labs and many practices warranty bridges 1-5 years against material failure).
• Chief complaint — in the patient's own words ("a piece of my upper front bridge chipped off when I bit into a bagel," "the back tooth on my bridge feels loose," "the gap under my bridge is open and food is packing in"). The patient narrative usually surfaces the cause and the timing.
• Reason for service — short clinical statement: porcelain fracture of the labial of pontic #X, connector fracture between #Y and #Z, distal retainer decementation on #W, etc. Name the failure mode explicitly — auditors read "bridge repair" with no failure mode and pend the claim for narrative.
• Bridge location — exact tooth numbers including abutments and pontic site(s). "Bridge #14-x-16" reads more clearly than "upper left bridge."
• Units — total units on the bridge (3-unit, 4-unit, 6-unit anterior, etc.). Drives the carrier's clinical-reasonableness check on the repair fee.
• Type of repair — the failure category and the specific lesion: porcelain chip vs. through-the-coping fracture; connector fracture vs. solder-joint fracture; pontic body fracture vs. occlusal fracture; one-side decementation vs. fully retained.
• Photographs — pre-repair and post-repair clinical photos are the single highest-impact attachment on a D6980 claim. Many carriers' clinical reviewers approve repair claims on photo evidence alone; absent a photo, the same claim pends for narrative or denies. Document the photos in the chart.
• Radiographs reviewed/taken — periapical or bitewing of the bridge and abutments, evaluating: caries on the abutment margins (the leading cause of decementation), bone level around abutments, integrity of any abutment endo, and PA pathology. A bridge that is decementing because of recurrent caries on an abutment is not a D6980 / D6930 candidate — it is a bridge replacement candidate, and trying to recement over caries is a recoupment risk.
• Cause — fracture of porcelain from occlusal overload (heavy bruxism, opposing implant prosthesis, opposing natural cusp tip), connector failure from a thin connector cross-section in a long-span bridge, abutment decementation from recurrent caries, decementation from inadequate retention form on a short / over-tapered preparation, traumatic fracture from a non-occlusal blow. Cause is not optional — it drives the recurrence-pattern decision and the repair-vs-replace conversation.
• Repair workflow — chairside vs. lab. For a chairside porcelain repair: surface preparation (diamond roughening, hydrofluoric acid etch on glass-ceramic, sandblast on zirconia, silane coupling, opaque, composite layering, polish); composite brand and shades; isolation method. For a lab repair: bridge removal technique (atraumatic if possible — crown remover, ultrasonic, KaVo CoroFlex), temporary fabrication and cementation, lab name and instructions, return interval, recement workflow on redelivery. Many practices document only "repair completed" — that's insufficient on a by-report code.
• Repair details performed today — what was actually done at this visit: damage assessed and characterized, repair material applied or bridge sent to lab, fit re-verified, occlusion checked, bridge recemented if removed, contacts and embrasures verified, polish completed.
• Material used — composite brand (e.g., 3M Filtek Universal A2/B2), shade(s), bonding system; or for cementation on recement, cement brand and lot (RelyX Unicem, FujiCEM 2, RMGI vs. resin); or for lab repair, the lab and the workflow.
• Fit / margin / contact / occlusion verification — explicit confirmation that margins seat, contacts close on floss without shred or open-contact food impaction, occlusion is even with no working / non-working interferences, and there is no rocking or visible gap under load.
• Patient instructions — soft diet for 24-48 hr after composite repair (let the bond mature), avoid biting hard objects on the repaired site (ice, hard candy, popcorn kernels, bones), brush and floss normally, return immediately for any sensitivity, looseness, or recurrence of the chip / fracture. Document explicitly that the patient was informed a repaired bridge is structurally compromised at the repair site and may re-fracture or de-cement — industry-standard counseling that protects the practice on recurrence.
• Replacement discussion — even when the repair is successful today, document the conversation: bridge age, prognosis, signs of end of life, alternative of a new bridge or implant-supported solution, the patient's choice, and the no-warranty status of the repair. This is the single most important field for defending a D6980 claim that the carrier may want to alternate-benefit toward replacement. If the repair was not feasible and replacement is being planned, document the discussion of replacement options (new tooth-supported bridge, implant-supported crowns, removable partial) and the consent or referral for the replacement workflow.
• Complications — explicitly noted, even if "none." Common items: post-op sensitivity on an abutment after recement, esthetic shade mismatch at a chairside porcelain repair, occlusal interference after composite addition, soft-tissue irritation from rough composite at a margin.
• Patient tolerance / response — did the patient seat and function comfortably, accept the esthetics, leave with a stable bite.
• Next visit — typical follow-up is a 1-2 week post-repair check for sensitivity, occlusion, and the integrity of the repair, then return to normal recall cadence. If replacement is being planned, document the timing and the sequence.

The "amnesia test" applies: a third party reading the note must be able to reconstruct (1) which bridge, (2) what failed and why, (3) what was actually done, and (4) why repair (not recementation, not replacement) was the right answer. Default-normal autotext ("bridge repaired, fit verified, no complications") is a known recoupment pattern in payer audits of high-volume restorative practices.

Common denial reasons

The most common reasons D6980 is denied, downgraded, or recouped:

• No narrative submitted — D6980 is by-report; a claim with no narrative is auto-pended on most carriers and denied if the narrative isn't supplied within the carrier's window. The single most preventable denial on this code.
• Narrative is generic or autotext — "bridge repaired, fit verified" tells the carrier nothing about what failed, what was done, or why repair was the right answer. Pended for additional records or denied for insufficient documentation.
• No pre-treatment photo or radiograph — for a by-report code, photo / image evidence of the damage is the strongest possible support. Absent imaging, the carrier has only the narrative, and many will downgrade or deny.
• 6-month post-delivery exclusion — bridge delivered fewer than 6 months ago; carrier denies as warranty-period repair. The original lab or fabricating practice is expected to remake at no charge.
• Wrong code submitted (D6980 instead of D6930). D6980 billed when an intact bridge simply came off and was recemented — the correct code is D6930. Common cause of recoupment when audited.
• Wrong code submitted (D6980 instead of D6090). D6980 billed for repair of an implant-supported FPD; the correct code is D6090 (repair implant-supported prosthesis, by report). Wrong-family denial.
• Frequency exceeded — second D6980 on the same bridge within the carrier's lookback (typically 12-24 months); the claim alternate-benefits toward replacement or denies with "consider new prosthesis."
• Recurrent caries on the abutment radiograph — the carrier sees the PA shows decay under the retainer and denies the repair / recement, citing that the appropriate code is replacement (D6240 / D6750) after caries removal. Recementing or repairing over recurrent caries is a recoupment risk on audit.
• Repair fee exceeds replacement allowance — when the repair fee is more than ~50% of a replacement bridge fee, some carriers automatically alternate-benefit to the replacement allowance and deny the repair.
• Bridge older than the plan's replacement frequency — some carriers refuse to authorize a repair on a bridge older than 5-7 years; the carrier's expectation is a replacement claim, and the repair is denied.
• Bridge is on an implant abutment — claim filed as D6980 when the abutment is an implant; denied as wrong family. Use D6090 / D6092 / D6093.
• D6980 billed same day as D6930 on the same bridge — denied as included; the repair allowance is presumed to include any incidental recementation.
• D6980 billed same day as the abutment crown / pontic codes that would constitute a replacement (D6240 + D6750) — the carrier reads the same-day combination as a replacement workflow and denies the D6980 as bundled.
• No tooth-numbering / unit-count in the narrative — carrier cannot verify which bridge or how many units; pended for records.
• Default-normal templating across many D6980 claims in the practice — every chart note reads "porcelain fracture, repaired with composite, fit verified" with no patient-specific findings. State payer integrity audits cite this pattern as evidence of fabricated documentation and recoup retroactively.
• Repair on a bridge that the carrier did not previously benefit — some carriers will not pay a repair on a prosthesis they never paid for originally; some will. Verify before submitting.

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