How do we bill a Maryland Bridge?

Answer

Following is a list of the codes you can use for the Maryland Bridge retainers (which most of us still refer to as abutments) as well as the codes used for the pontics.

D6545 - retainer - cast metal for resin bonded fixed prosthesis
Use to bill the retainer/abutment for a Maryland Bridge when made of cast metal.

D6548 - retainer - porcelain/ceramic for resin bonded fixed prosthesis
Use to bill the retainer/abutment for a Maryland Bridge when made of porcelain/ceramic material.

D6549 - resin retainer - for resin bonded fixed prosthesis
Use to report resin bonded fixed prosthesis. 

D6210-D6252 Fixed Partial Denture Pontics
Report Maryland Bridge pontics separately using the appropriate code from the D6200 series.

Typical charges:

The typical fee for each Maryland Bridge retainer (abutment) is 1/2-3/4 of your pontic fee. The total fee for the Maryland Bridge would be 2/3 or more of a full 3-unit bridge fee.

Issues that impact reimbursement for Maryland Bridges:

• Missing tooth clauses
• Congenitally missing tooth exclusions
• Waiting periods
• Plan and/or “major” maximums
• Minimum age restrictions for prosthetics