Read and print out these instructions for dental code D2740 so you can refer to it each time you have a question.
D2740: Crown porcelain/ceramic
Purpose: Esthetic full-coverage crown
- This code should be used only when reporting a porcelain/ceramic or zirconia crown.
- Dental insurance companies will refer to the patient plan's limitations and exclusions when considering the dental claim.
- Dental PPO plans will reimburse when placing the porcelain/ceramic crown when placed in the esthetic zone (anterior region of the mouth).
- Should the PPO plan pay for an alternate benefit, such as a PFM, you can only charge the patient the difference between the contract rate for ceramic and the paid rate, if you are in-network.
- Most PPO dental plans limit reimbursement for crown replacement to every 10 years, regardless of material.
- Most PPO dental plans will not reimburse for porcelain/ceramic crowns when placed in the posterior region of the mouth.
- Should decay not be visible on the x-ray, include a narrative with the x-ray indicating location of such decay.
- If in-network with the PPO plan, you are usually required to submit for reimbursement on the seat date and not the prep date.
- Submitting the claim with x-rays is not enough to facilitate coverage and payment.
- If the tooth is root canal-treated, indicate that endo treatment has been completed and include a post-op x-ray and endo report.
- Pre-op and Post-op x-rays must always accompany the claim form.
More Coding with Kyle:
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- Coding with Kyle: Overdenture coding after implant placement
Kyle L. Summerford is a nationally recognized practice management guru, author, and lecturer. He is founder and president of Summerford Solutions Inc., and cofounder of Elitedentalclaims.com. Kyle also serves as editorial director of Dental Office Manager Digest e-newsletter. He lectures extensively to dentists and their staff on topics such as insurance coding and billing and useful practice management tips. Contact him at [email protected].
