What should the Implant Crown Scan chart note include?
Pick your PMS to format the placeholders, then copy.
Implant crown scan/impression. RMH: Medical history reviewed/updates Implant prosthesis support: Extraction/implant placement dates, implant system, abutment/component records Support/retention type: Implant-supported vs abutment-supported; screw/cement retention Maintenance findings: Peri-implant tissue, bone level/radiographs, occlusion, hygiene access Torque/component details: Torque values, screw access, O-rings/gaskets/attachments if applicable Implant site: #Tooth number(s) Implant system: Implant system Procedure: Healing abutment removed. Implant platform examined. Scan body placed. Intraoral scan taken. Bite registration recorded. Shade selected: Shade Healing abutment replaced. Crown type ordered: Crown type ordered Screw retained. Cement retained. Abutment type: Abutment type Complications: None or describe. Patient tolerance: Tolerance/response. NV: Next visit
What documentation is required for Implant Crown Scan?
The scan / records visit is documented for two audiences: the lab (so the case can be fabricated correctly) and the future auditor (so the bundling and ultimate billing are defensible). A defensible note includes:
- Medical history review and update — meds, conditions, allergies, anti-resorptive therapy (bisphosphonates, denosumab — affects peri-implant bone), uncontrolled diabetes, smoking status, and any conditions affecting peri-implant tissue. State what changed since last visit; "no changes" is acceptable but should be written, not omitted.
- Implant site and tooth number — Universal or FDI tooth number being restored. If multiple sites are being scanned at the same visit, document each.
- Implant placement history — extraction date (if known), implant placement date, placing surgeon (in-house or referring, with referral records on file), and implant system / brand / platform / diameter / length when available. The system drives scan-body selection, abutment-component compatibility, and ultimate torque specification. Carriers reviewing the eventual prosthetic claim will want the system named in the chart.
- Osseointegration confirmation — date of stage-2 uncovery (if two-stage), ISQ value or clinical confirmation of osseointegration (no mobility, no pain on percussion, no peri-implant radiolucency on the most recent PA), and that the implant is ready to restore. Most carriers expect a minimum healing interval of 3-4 months (mandible) or 4-6 months (maxilla) before the prosthesis is delivered.
- Peri-implant tissue assessment — soft-tissue color, contour, attachment, probing depths around the implant, bleeding on probing, and any signs of peri-implant mucositis or peri-implantitis. Photograph the emergence profile if relevant. If tissue is not healthy, the records visit is deferred — document why.
- Scan-body placement and verification — that the healing abutment was removed, the implant platform was examined and clean, the correct scan body for the implant system was seated and engaged, and that engagement was verified (visually, tactilely, and via the scan software's fit check).
- Intraoral scan — scanner brand and model (e.g., 3Shape TRIOS, iTero Element 5D, Medit i700), arches scanned (the implant arch and the opposing arch), and that the scan included the adjacent teeth at minimum two on each side for occlusal context. Note any rescan, retake, or stitching issue.
- Bite registration — method (digital scanned bite, PVS bite registration, or wax) and that the bite was verified bilaterally in MIP. For complex occlusal cases, document any deprogrammer or splint use.
- Shade selection — shade with brand of guide (e.g., "A2, Vita Classical"), digital shade match if used, and any custom characterization request to the lab. Photograph with shade tab adjacent for lab reference when esthetics are demanding.
- Healing abutment replaced — explicit: scan body removed, healing abutment retorqued to the manufacturer's healing-abutment specification (typically 10-15 Ncm), patient confirmed comfortable, screw access not needed (healing abutment is not a definitive restoration).
- Crown type ordered — material (monolithic zirconia, lithium disilicate, layered zirconia, PFM), brand if relevant, and the retention scheme (screw-retained vs cement-retained). The lab slip and chart should agree.
- Abutment type ordered — prefab stock (D6056), custom milled titanium (D6057), custom milled zirconia (D6057), one-piece zirconia, or TiBase integral to a screw-retained crown (typically not separately reported, drives a D6065 crown). The decision drives the eventual claim coding (D6056 + D6058 vs D6057 + D6058 vs D6065-only).
- Retention scheme — screw-retained or cement-retained, explicitly. For screw-retained cases, document the planned screw-access location and angulation; if the angulation is unfavorable, an angled screw channel (ASC) abutment may be needed and should be specified to the lab.
- Lab and lab instructions — lab name, written instructions sent (signed and dated, copy in chart), and estimated return date. The lab slip should specify the implant system, platform, the scan-body file, the abutment design and screw to be used, the crown material, and the retention scheme.
- Image support — recent PA showing stable peri-implant bone with no PARL or thread exposure (should be on file from uncovery or taken today if more than ~3 months old). Diagnostic-quality, labeled with site and date.
- Complications — explicitly noted, even if "none." Common: scan-body engagement issue requiring retake, peri-implant tissue inflammation deferring the visit, soft-tissue overgrowth requiring laser troughing before scan, bleeding obscuring the platform.
- Patient tolerance / response — how the patient tolerated healing-abutment removal, scan, and replacement. Most patients require no anesthesia for this visit; document if local was used and why.
- Next visit — typical: crown delivery in 2-3 weeks once lab returns the case. Document any planned try-in if the case is complex (multi-unit, esthetic anterior, custom abutment requiring fit verification).
- Billing intent — note explicitly in the chart how the case will eventually bill ("records visit, no fee today; abutment + crown to be billed at delivery as D6057 + D6058" or similar). This single line prevents downstream confusion and supports the bundling decision if audited.
The "amnesia test" applies: a third party reading the note must be able to reconstruct (1) which implant is being restored and what system it is, (2) what abutment and crown were ordered and at what retention scheme, (3) the shade and material, and (4) why this visit is or is not billable. Default-normal autotext that doesn't name the implant system, the abutment-reporting decision, or the lab order is the single biggest red flag if the eventual prosthesis is audited.
Why does Implant Crown Scan get denied?
Because the scan / records visit is not separately billed in most workflows, denials specific to the visit are rare. The denials below apply to attempts to bill the records visit as a stand-alone service, and to the eventual abutment and crown when the records-visit documentation is weak.
- D9999 records visit denied as bundled — carriers treat the scan / impression / lab-order visit as inclusive of the abutment and crown under the "includes modification and placement" descriptor. Stand-alone records billing is denied as bundled. Document as patient-pay if the visit is being separately charged.
- D0470 (diagnostic casts) denied as bundled — most carriers bundle diagnostic casts into the prosthesis fee when the casts are part of the prosthetic workup. Stand-alone D0470 is reimbursable only when the casts are clearly diagnostic and pre-decisional (e.g., before a final prosthetic plan exists).
- D6056 / D6057 / D6058 / D6065 billed on the scan date — the abutment / crown procedure is not complete until delivery. Submitting on the scan date is a frequent cause of recoupment when the carrier's auditor matches the date of service against the chart's delivery date.
- No torque value in the chart at delivery — the records visit chart documents the lab order (abutment type, retention scheme, screw type), but the torque value belongs to the delivery visit. If the delivery chart is missing the torque value, the eventual abutment / crown can be downgraded or denied for documentation deficiency. The records-visit chart should plan the torque (per manufacturer); the delivery chart records it.
- Implant system not named — the records-visit chart that doesn't name the implant system, platform, or scan body makes it impossible for an auditor to verify component compatibility. Carriers reviewing the eventual prosthesis often request the system; if it's not in the chart, payment is delayed.
- Abutment-reporting decision not stated — the records-visit chart that doesn't say "screw-retained, no separate abutment to be reported" or "cement-retained, custom abutment ordered as D6057" leaves the bundling decision ambiguous. Eventual claim is reprocessed when the carrier sees an apparent mismatch between abutment line and crown line.
- Same-day attempt to bill abutment + crown on the scan date — the abutment placement and crown delivery happen at the delivery visit, not the scan visit. Billing both on the scan date will be denied (no procedure performed) or recouped on audit.
- Pre-authorization not obtained before scan — most carriers require pre-auth for the abutment and crown before the case is fabricated. If the records visit happens without pre-auth and the case is fabricated, the carrier's eventual response may be a partial payment or denial that the practice now owns. Always pre-auth before the records visit, not after.
- Records visit charged to the patient without disclosure — if the practice charges the patient a separate "records fee" without disclosing it as non-covered up front, this can be a state-board complaint. Document that the patient was informed the records visit is part of the global prosthetic fee, or that it is a separately disclosed fee, before the visit begins.
What do practices ask about Implant Crown Scan?
Is the implant scan / records visit a billable CDT code?+
Not in most workflows. The scan / records visit is bundled into the eventual abutment fee (D6056 or D6057) and / or the crown fee (D6058 / D6065 / D6066 / D6067) billed at delivery. The ADA descriptors for D6056 and D6057 explicitly say "includes modification and placement," which most carriers interpret as covering the records visit, the lab order, the fabrication, and the placement as a single global fee. Practices that need to charge for the records visit as a stand-alone item typically do so as a patient-pay records fee, disclosed up front.
Can I bill D9999 for the records visit?+
Sometimes, with caveats. D9999 (unspecified adjunctive procedure, by report) requires a narrative and is reviewed by the carrier on a case-by-case basis. Carriers generally deny D9999 for routine prosthetic records because the visit is considered bundled. D9999 has a better chance of payment when the records visit is genuinely pre-decisional (e.g., scan and treatment planning before a final prosthetic plan exists, before any fabrication has been authorized). Even then, expect denials and budget the charge as patient-pay or appeal-only.
What date of service do I bill the abutment (D6056 / D6057) and crown (D6058 / D6065)?+
The delivery date, not the scan date. The abutment and crown are billed when the procedure is complete — when the abutment is placed, the crown is seated, and torque is applied. Submitting on the scan date is a common cause of recoupment because the carrier's auditor will reconcile the date of service against the chart's delivery date and find a mismatch. Document the records visit as records-only with no fee, and bill the CDT codes on the delivery chart.
Do I need pre-authorization before the scan visit?+
Yes, for almost all PPO carriers. Most carriers require pre-authorization for the abutment (D6056 / D6057) and crown (D6058 / D6065 / D6066 / D6067) before the case is fabricated. The pre-auth submission should happen before the scan visit so the carrier's response is in hand by the time the lab is engaged. Submitting after the case is fabricated puts the practice at risk if the carrier denies or downgrades — the lab fee is already incurred, and the practice now owns the difference.
What goes in the lab slip from the records visit?+
Implant system, platform, diameter, length; the scan-body file (digital workflow) or impression (analog); the abutment design (prefab stock manufacturer / part, custom milled titanium, custom milled zirconia, or TiBase for screw-retained); the prosthetic screw to be used; the crown material (monolithic zirconia, layered zirconia, lithium disilicate, PFM); the retention scheme (screw or cement); the shade with brand of guide; any custom characterization request; and the screw-access location and angulation if screw-retained. Sign and date the prescription, and keep a copy in the chart.
How is this visit different from the implant crown delivery visit?+
Two separate visits, two separate templates. The scan / records visit captures the case for the lab — healing abutment off, scan body in, intraoral scan, bite, shade, lab order, healing abutment back on. The delivery visit places the final abutment (or seats the screw-retained crown directly), torques to spec, adjusts contacts and occlusion, and seals the screw access. The CDT codes (D6056 / D6057 / D6058 / D6065 / D6066 / D6067) are billed at the delivery visit, not the scan visit.
Can I take a PA at the scan visit and bill D0220?+
If the PA is clinically indicated and not duplicative of an existing recent image. Most records visits don't need a new PA because a recent uncovery PA or pre-restorative PA is on file. If the chart's most recent PA is more than ~3 months old, or peri-implant tissue raised a concern at this visit, a new PA at the records visit is reasonable and reimbursable as D0220. Document the clinical indication; carriers will deny PAs taken "because we always do one at the scan visit" as bundled with the prosthesis.
Which templates are related to Implant Crown Scan?
Prefabricated Abutment — Includes Modification and Placement Template
vs. MISC_IMPLANT_CROWN_SCAN
Custom Fabricated Abutment — Includes Modification and Placement Template
vs. MISC_IMPLANT_CROWN_SCAN
Implant-Supported Porcelain/Ceramic Crown Template
vs. MISC_IMPLANT_CROWN_SCAN