D6190 is the CDT code for a radiographic/surgical implant index, reported by report. It describes a diagnostic index or guide used during implant planning to relate the intended implant position to the bone, adjacent teeth, and soft tissue before surgery.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Use D6190 when fabricating a radiographic or surgical index that relates the planned implant position to the patient anatomy. This index helps the surgeon visualize the bone, adjacent teeth, and soft tissue so the implant can be placed in the ideal position for the eventual restoration.
D6190 covers the index or guide used to translate the restorative plan into the surgical plan. It links where the final tooth needs to be with where the implant must go, which reduces the risk of poor angulation or position.
D6190 is a by report code, so it has no fixed definition of technique or material. Every claim needs a written narrative that explains what was fabricated, the site involved, and how the index supported the implant plan. Without that narrative, the payer has nothing to evaluate.
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A diagnostic radiographic or surgical index used to plan implant position. It is a planning tool, not the surgery itself, and it is reported by report with a narrative.
Surgical placement of the implant body into the bone. This is the hands-on placement procedure that the D6190 index helps to plan.
Billing tip: D6190 supports planning, D6010 performs the placement. Some plans bundle the index into the placement fee, so confirm whether D6190 is separately reimbursable before billing it alongside D6010.
D6190 is reported by report, so the narrative is the claim. A reviewer cannot approve a by report code without a clear description of what was fabricated and why. A vague note that just repeats the code description gets denied. Describe the index, the site, and the planning purpose in plain detail.
Some plans consider the planning index part of the implant placement fee. When that is the policy, D6190 is denied as inclusive of D6010. Verify whether the index is separately payable under the patient plan before billing it on its own line.
If the plan excludes implant services, related planning codes like D6190 are excluded too. The denial is a benefit exclusion, not a documentation problem. Confirm implant coverage during verification and set patient expectations early.
The index must connect to an actual implant treatment plan. If the documentation does not show a planned implant site and a restorative goal, the payer has no basis to pay for a planning tool. Include the case context in the narrative.
Write a clear narrative describing the index or guide that was fabricated, the materials or method used, and how it supported the implant plan. This is the most important part of a D6190 claim.
Identify the site and the planned implant position the index relates to. Tie the index to a specific implant treatment plan so the payer can see the purpose.
Include the radiographic images or scan used in planning. They show the bone and anatomy the index was built around and support the medical necessity of the planning step.
Document the intended final restoration so the reviewer understands why the index was needed to relate implant position to the planned tooth.
Record whether the plan covers the index separately or bundles it. Confirm implant coverage before treatment and note the patient responsibility if D6190 is not payable.
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Learn about our billing servicesD6190 is the CDT code for a radiographic/surgical implant index, reported by report. It describes a diagnostic index or guide used in implant treatment planning to relate the planned implant position to the bone, teeth, and soft tissue.
D6190 has no set definition of materials or technique, so it is reported by report. The provider must submit a written narrative describing what was fabricated, how it was used in planning, and why it was needed for the case.
D6190 covers the radiographic and surgical index used to plan and relate implant position. Practices often use it for the planning index or guide, but because it is by report, the narrative must clearly describe what was made and how it supported the implant plan.
Common reasons include a missing or vague by report narrative, the service being bundled into the implant placement fee, implants being a non-covered benefit, and no documentation tying the index to a planned implant case.
Yes. As a by report code, D6190 requires a written narrative. The narrative should describe the index or guide that was fabricated, the planning purpose, the site involved, and how it contributed to the implant treatment plan.
No. Many plans bundle planning indices into the implant procedure or exclude implant services entirely. Verify benefits before treatment and inform the patient when D6190 may not be reimbursed so there is no surprise balance.
Search all 206 CDT codes in our dental coding guide.