CDT D2740 Dental Procedure Code
Few facts about this dental procedure code while submitting the insurance claim:
- This D2740 is the esthetic full-coverage crown reporting porcelain/ceramic dental procedures. With this dental procedure code, a prosthetic crown placed over a chipped, cracked, damaged, or decayed tooth yields positive cosmetic results.
- When considering the dental claim about the full-coverage crown, the insurers refer to the patient’s benefits plan, limitations, and exclusions.
- Dental PPO plans will reimburse for the prosthetic porcelain/ceramic crown fitted over the tooth within the smile zone. Porcelain crowns are lighter than the ceramic and give a more natural look.
- Most PPO dental plans limit the reimbursement for a crown replacement to every ten years, irrespective of the material used.
- If you are an in-network provider, in that case, you can charge the patient the difference between the contract rate for ceramic and paid rate.
- For the in-network PPO dental plan, include the seat date and not the prep date for the reimbursement.
- Charging an additional fee for a crown upgrade is not acceptable for PPO plans. The provider can bill for the rendered service supported by the documents, narrative and miscellaneous code. As it is an out-of-pocket payment for the patient, be very clear with all the details about the material and what is different from the covered service.
- Most PPO dental plans will not reimburse for the ceramic/porcelain crown placed in the rear/posterior region of the mouth.
- The revision in the codes from 2018 has removed the word substrate to eliminate the confusion of application to zirconium crowns. D2740 will reimburse for porcelain/ceramic crowns and not the zirconium.
- When using the dental code D2740, if tooth decay is not visible on the x-ray, that can be documented with a narrative indicating the location of the tooth decay.
- To smooth the process of coverage and payment, submitting the claim with x-rays is not enough.
- Also, for root-canal treatment, supporting information like an endo report with post-op x-ray indicate the completion of endo treatment.
- The claim form always has the pre-op and post-op x-rays to accommodate the procedure.
How much does a prosthetic crown cost?
As per ADA code D2740, the regular fee for the procedure is $1,168. The covered service depends upon the plan and its benefits, although if you want to upgrade from a full cast-metal to a porcelain crown, your patient has to pay the cost difference if not included in their plan.
