Every Friday afternoon, at dental offices, it is more or less the same story: the pile of EOBs (Explanation of Benefits) comes, and right there, beside your most profitable restorative cases, you see the word Denied. We are aware that the decision of selecting the appropriate crown dental code would hardly be as easy as it appears in a drop-down menu.
For the US doctors and medical care practices, 2026 has come with a much stricter leash on reimbursements. When your team continues to confuse a D2740 with a D2750, you are not simply committing a clerical error; you are actually putting thousands of dollars in that pending tray, and you are also exposing yourself to a possible audit by Medicaid. So let’s discuss how to come out of this situation through this blog.
The CDT (Current Dental Terminology) manual is extremely precise. Any misrepresentation of the material of a crown may be termed as upcoding or downcoding, which are warning signs to auditors.
The most used dental code in the US is now the D2740 code. It is applicable to all-ceramic, all-porcelain, or zirconia restorations. Since they are metal-free, they become the gold standard in regard to the anterior teeth.
It is applied to PFM crowns in which the metal base structure has no less than 60% noble metal (gold, platinum, or palladium), at least 40% of which is gold. This is usually the right decision in case you place a dental code for a gold crown, but the overlay is porcelain.
This is the standard gold crown dental code for a full gold crown with no porcelain overlay. It is prized for its durability in high-stress posterior regions.
If a patient comes in with a dislodged crown that is still serviceable, you use the dental crown recement code (D2920). It is worth mentioning that in the vast majority of insurance plans, there is some frequency limit on this, usually a year or two.
If you are confused between different CDT codes, then Capline has got you covered. We ensure crown claims are accurate, compliant, and profitable in 2026.
The most frequent error that we have encountered when sitting down with a practice to audit their billing is that they do not communicate between the back office and the front office. The clinician is aware of the material, whereas the biller selects the common code.
A lot of physicians will question, Can I charge for a repair rather than a replacement? The answer is yes, but with conditions.
The successful claim is based on clinical necessity. In order to be able to utilize a crown dental code, you need to be able to support one of them in your clinical notes:
The repercussions of improper coding are not simply that of a delayed payment.
The ability to master the Crown Dental Code System is critical to any practice that wants to keep a healthy cash flow in 2026. It is one way to secure your practice against unnecessary rejection by differentiating between the D2740 dental code and metal-based alternatives and making sure that your Medicaid legacy number is good.
Would you have our team do a coding audit of your 2026 claims? Contact us today. At Capline, we make sure that your restorative claims are attended to with accuracy.
D2740 is for all-porcelain/ceramic crowns, ideal for aesthetics without metal. D2750 covers porcelain fused to high-noble metal, offering strength for load-bearing areas. The key distinction is the material composition chosen based on clinical necessity to avoid denials.
Crown codes differentiate by alloy: high noble (60%+ noble metals, e.g., D2750, D2790), noble (25%+ noble, e.g., D2752, D2792), and predominantly base (mostly non-noble, e.g., D2751, D2791). High noble provides superior biocompatibility but higher cost.
Costs vary by material (porcelain $800-$1,500, gold $1,000-$2,000), location (urban vs. rural), and lab fees. Insurance reimbursement averages 50-80%, but wrong coding can reduce this. Patient factors like position and complexity also influence pricing.
No direct changes to core crown codes in 2026, but new implant and sedation codes may impact related procedures. Administrative trends include stricter prior authorizations and emphasis on narratives for insurance.
The temporary crown ADA code is D2799: Provisional crown. Use it for interim restorations pending final placement, ensuring documentation shows it's not the definitive treatment.
D2920: Re-cement or re-bond crown. This applies to loose crowns; include a narrative explaining the reason for reimbursement.
D2790: Crown - full cast high noble metal. For non-high noble, use D2791 (base) or D2792 (noble), depending on alloy composition.
