D2740: Crown – Porcelain/Ceramic
As explained by the experts at DentalRevu, A CAD/CAM porcelain/ceramic crown restoration milled from a Vita®/Procad® block and a zirconium crown would be reported using the D2740 dental code. When evaluating a dental claim, dental insurance companies will refer to the patient plan’s limitations and exclusions.
Dental PPO insurance will reimburse for porcelain/ceramic crown placement in the aesthetic zone (anterior region of the mouth). If the PPO plan covers an additional benefit, like 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.
What are the Warnings of the D2740 Dental Code?
- Reporting a crown placed on a normal tooth is deceptive if the restoration is an implant supported or abutment supported crown.
- Reporting retainer crowns of a fixed bridge as a single crown(s) in order to earn a bigger reimbursement is deceptive.
- (A single unit crown can be reimbursed at 80% of the UCR fee, while a retainer crown can be refunded at 50% of the UCR fee.)
Please Note: Vita®, Lava Ultimate®, ProCad®, Empress®, Procera®, InCeram®, Lava®, Finesse®, Cerinate®, Zirconia®, BruxZir®, Opc®, and e-max® are examples of porcelain materials.
What are the Limitations of the D2740 Dental Code?
- Facial veneers should not be referred to as a porcelain/ceramic crown (D2740).
- The majority of payers have an age restriction exclusion. They will not pay for a permanent crown unless the patient is between the ages of 12 and 13.
- If the patient is under the age of 18, always check to see if there is an age used exclusion before beginning therapy.
- The plan may limit reimbursement for crown replacement, which can range from five to ten years after the last placement.
- The trend is approaching ten years. This replacement exclusion may be overridden if there is a trauma that necessitates a new crown.
- As an alternative benefit, D2740 may be reimbursed as a porcelain fused to metal crown or a gold metal crown.
- The material (porcelain/ceramic) utilised for the restoration should be accurately reflected in the code used to register the restoration.
- The material used should be consistent with what is documented in the insurance claim form, treatment plan, clinical note, or lab slip.
Why It’s Important to Outsource D2740 Dental Code Billing?
Your practice can run more efficiently using DentalRevu. We are a full-service dental billing company with the best in the field on board, and we have a proven track record of delivering outstanding services utilizing tried-and-true methods.
As a result of our better procedures and flawless dental insurance verification, we help you alleviate your patients’ anxieties and increase their satisfaction. Our cutting-edge, forward-thinking solutions help you save time, earn more money, and reduce your stress levels.