D6081ADA CDT ProcedureImplant ServicesPARTIAL DENTURE PONTICS
D6081 - Implant Cleaning
Scaling/debridement in presence of mucositis.
Patient-Friendly Summary: A focused therapeutic cleaning and debridement performed around an implant experiencing gum inflammation (peri-implant mucositis). Deep deposits and bacteria are gently removed to stop inflammation and prevent bone loss around the implant.
Clinical Documentation Notes: Covered for Choice Plus. Not conjunction with D1110/D4910.
- Procedure Code
- D6081
- Clinical Category
- Implant Services
- Primary ICD-10 Justification
- K05.312 (Chronic periodontitis, localized, moderate)
- Reference Fee & Claim Types
- BOTH
Insurance Verification Benchmarks & Billing Guidelines
Payer policy benchmarks, pre-submission attachment requirements, and denial prevention rules for D6081.
- Frequency Limitation
- 1 per tooth/site in a 60-month interval (5 years) (rolling_12_months)
- Age Limitation Criteria
- Restricted to patients age 19 or older. Implants are not a benefit for patients under 19 years of age.
Required Claim Attachments & Pre-Submission Checklist
- Post-operative radiograph or surgical operative report
Bill When (Allowable Clinical Criteria)
- Benefits are limited to once per tooth per 24 months.
Restrictions & Clinical Exclusions
- Fees for D6081 are not billable to the patient when performed in the same quadrant by the same dentist/dental office as D4341/D4342 or D4240/D4241, D4260/D4261, D6049, or D6101/D6102.
- Fees for retreatment by the same dentist/dental office within 24 months of initial therapy are not billable to the patient, if different dentist/dental office then benefits are denied.
- Fees for D6081 are not billable to the patient when performed within 12 months of restoration (D6058-D6077, D6085, D6094, D6118, D6119, D6194) placement by same dentist/dental office.
- Fees for D6081 are not billable to the patient when performed in conjunction with D1110, D4346 or D4910.
- For benefit purposes, anesthesia is an integral part of the procedures being performed and additional fees are not billable to the patient.
- Benefits are denied, unless the group/individual contract specifies that implant services are a benefit.
Common Claim Denial Codes & Overturn Strategies
| Denial Code | Denial Reason | Appeal & Overturn Strategy |
|---|---|---|
| CO-119 | Benefit maximum or frequency limitation exceeded for procedure | Submit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria. |
ICD-10-CM Justification & Crosswalk Mappings for D6081 (29)
Click any ICD-10-CM diagnosis code below to inspect its reverse procedure mappings and differential coding guide.
| ICD-10 Code | Diagnosis Name | Category | Primary Justification | Claim Type | Clinical Scenario |
|---|---|---|---|---|---|
| K05.312 | Chronic periodontitis, localized, moderate | Gingivitis and periodontal diseases | ★ Yes (Primary) | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Chronic periodontitis, localized, moderate |
| A69.1 | Other Vincent’s infections | Other spirochetal infections | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Other Vincent’s infections |
| E10.9 | Type I diabetes mellitus without complications | Diabetes mellitus | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Type I diabetes mellitus without complications |
| E11.A | Type 2 diabetes mellitus without complication in remission | Diabetes mellitus | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Type 2 diabetes mellitus without complication in remission |
| E11.9 | Type 2 diabetes mellitus without complications | Diabetes mellitus | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Type 2 diabetes mellitus without complications |
| K03.6 | Deposits [accretions] on teeth | Other diseases of hard tissues of teeth | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Deposits [accretions] on teeth |
| K05.20 | Aggressive periodontitis, unspecified | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Aggressive periodontitis, unspecified |
| K05.211 | Aggressive periodontitis, localized, slight | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Aggressive periodontitis, localized, slight |
| K05.212 | Aggressive periodontitis, localized, moderate | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Aggressive periodontitis, localized, moderate |
| K05.213 | Aggressive periodontitis, localized, severe | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Aggressive periodontitis, localized, severe |
| K05.219 | Aggressive periodontitis, localized, unspecified severity | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Aggressive periodontitis, localized, unspecified severity |
| K05.221 | Aggressive periodontitis, generalized, slight | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Aggressive periodontitis, generalized, slight |
| K05.222 | Aggressive periodontitis, generalized, moderate | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Aggressive periodontitis, generalized, moderate |
| K05.223 | Aggressive periodontitis, generalized, severe | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Aggressive periodontitis, generalized, severe |
| K05.229 | Aggressive periodontitis, generalized, unspecified severity | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Aggressive periodontitis, generalized, unspecified severity |
| K05.30 | Chronic periodontitis, unspecified | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Chronic periodontitis, unspecified |
| K05.311 | Chronic periodontitis, localized, slight | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Chronic periodontitis, localized, slight |
| K05.313 | Chronic periodontitis, localized, severe | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Chronic periodontitis, localized, severe |
| K05.319 | Chronic periodontitis, localized, unspecified severity | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Chronic periodontitis, localized, unspecified severity |
| K05.321 | Chronic periodontitis, generalized, slight | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Chronic periodontitis, generalized, slight |
| K05.322 | Chronic periodontitis, generalized, moderate | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Chronic periodontitis, generalized, moderate |
| K05.323 | Chronic periodontitis, generalized, severe | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Chronic periodontitis, generalized, severe |
| K05.329 | Chronic periodontitis, generalized, unspecified severity | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Chronic periodontitis, generalized, unspecified severity |
| K05.5 | Other periodontal diseases | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Other periodontal diseases |
| K05.6 | Periodontal disease, unspecified | Gingivitis and periodontal diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Periodontal disease, unspecified |
| K06.1 | Gingival enlargement | Other disorders of gingiva and edentulous alveolar ridge | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Gingival enlargement |
| Z33.1 | Pregnant state, incidental | Pregnant state | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Pregnant state, incidental |
| Z72.0 | Tobacco Use | Problems related to lifestyle | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Tobacco Use |
| Z87.891 | Personal history of nicotine dependence | Personal history of certain other diseases | Secondary | BOTH | scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing and increased pocket depths; includes cleaning of the implant surfaces, without flap entry and closure indicated for Personal history of nicotine dependence |
Frequently Asked Questions — D6081 (Implant Cleaning)
Quick answers for dental billers and treatment coordinators submitting claims for D6081.
What ICD-10 diagnosis codes link to dental procedure D6081?▾
Common ICD-10-CM justification codes for CDT D6081 (Implant Cleaning) include: K05.312 - Chronic periodontitis, localized, moderate (Primary); A69.1 - Other Vincent’s infections; E10.9 - Type I diabetes mellitus without complications; E11.A - Type 2 diabetes mellitus without complication in remission; E11.9 - Type 2 diabetes mellitus without complications; K03.6 - Deposits [accretions] on teeth; K05.20 - Aggressive periodontitis, unspecified; K05.211 - Aggressive periodontitis, localized, slight; K05.212 - Aggressive periodontitis, localized, moderate; K05.213 - Aggressive periodontitis, localized, severe; K05.219 - Aggressive periodontitis, localized, unspecified severity; K05.221 - Aggressive periodontitis, generalized, slight; K05.222 - Aggressive periodontitis, generalized, moderate; K05.223 - Aggressive periodontitis, generalized, severe; K05.229 - Aggressive periodontitis, generalized, unspecified severity; K05.30 - Chronic periodontitis, unspecified; K05.311 - Chronic periodontitis, localized, slight; K05.313 - Chronic periodontitis, localized, severe; K05.319 - Chronic periodontitis, localized, unspecified severity; K05.321 - Chronic periodontitis, generalized, slight; K05.322 - Chronic periodontitis, generalized, moderate; K05.323 - Chronic periodontitis, generalized, severe; K05.329 - Chronic periodontitis, generalized, unspecified severity; K05.5 - Other periodontal diseases; K05.6 - Periodontal disease, unspecified; K06.1 - Gingival enlargement; Z33.1 - Pregnant state, incidental; Z72.0 - Tobacco Use; Z87.891 - Personal history of nicotine dependence.
Can CDT code D6081 be billed to medical insurance?▾
Billing CDT D6081 (Implant Cleaning) to medical insurance depends on the underlying clinical necessity and trauma/pathology documentation. Supported claim types across linked diagnoses: BOTH.
What attachments and documentation are required for billing CDT D6081?▾
Required claim attachments for CDT D6081 (Implant Cleaning) include: Post-operative radiograph or surgical operative report.
What is the insurance frequency limitation for CDT D6081?▾
Standard commercial insurance frequency for D6081: 1 per tooth/site in a 60-month interval (5 years) (rolling_12_months). Age criteria: Restricted to patients age 19 or older. Implants are not a benefit for patients under 19 years of age..
What are common insurance denial reasons and appeal tips for CDT D6081?▾
Denial Code CO-119 (Benefit maximum or frequency limitation exceeded for procedure): Overturn appeal strategy - Submit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria.