When is D2390 used?
The D2390 dental code applies to a resin-based composite crown, anterior. This CDT code is utilized when placing a complete-coverage, direct composite crown on a front tooth. Different from other composite codes covering fillings or partial repairs, D2390 is designated for cases where the complete clinical crown needs restoration because of significant decay, breakage, or prior restoration breakdown. Keep in mind that D2390 cannot be applied to back teeth or veneer procedures, which have their own specific codes.
D2390 Charting and Clinical Use
Proper documentation is essential when using D2390. Clinical records must clearly show:
The amount of tooth structure damaged (such as from cavities, injury, or restoration failure)
Why complete-coverage restoration is required rather than a standard filling
Before and after photographs or X-rays when available
Information about materials used and restoration procedures performed
Typical clinical situations include:
A young patient with a broken front tooth requiring a crown when traditional lab-made crowns are not suitable
Patients wanting an affordable, immediate solution for major front tooth damage
Situations requiring complete-coverage restoration where patients cannot receive porcelain or metal crowns
Billing and Insurance Considerations
To improve reimbursement and reduce claim rejections for D2390, dental practices should implement these strategies:
Check coverage: Prior to treatment, confirm the patient's insurance benefits for resin-based composite crowns on front teeth. Some policies may limit coverage to specific age ranges or clinical conditions.
Provide thorough documentation: Include detailed clinical records, before and after images, and explanatory notes about why complete-coverage restoration was required. This demonstrates medical necessity and helps avoid claim rejections.
Apply proper CDT code: Make sure D2390 is only used for direct, complete-coverage composite crowns on front teeth. For multiple-surface fillings, consider codes such as D2330 or D2332.
Handle denials properly: When claims are rejected, examine the Explanation of Benefits (EOB) for denial reasons and file an appeal with supplementary documentation, including intraoral images or more comprehensive narrative.
How dental practices use D2390
Case: A 16-year-old patient arrives with a broken upper central incisor (#9) from a sports accident. The break affects most of the visible crown, but the root remains intact and healthy. Following discussion of treatment options, the dentist and patient's parent choose a direct resin-based composite crown for immediate repair.
Processing steps:
Check insurance coverage for D2390 and secure pre-authorization when necessary.
Record the fracture extent with photographs and comprehensive notes.
Perform the restoration and document the treatment, including materials utilized.
Process the claim using D2390, including all supporting materials.
When claims are rejected, examine the EOB and file an appeal with extra clinical justification.
This method ensures proper claim support and improves the chances of prompt reimbursement.
Common Questions
Is D2390 appropriate for primary (baby) teeth?
D2390 is not suitable for primary teeth as it is specifically intended for permanent anterior teeth requiring full-coverage resin-based composite crowns. For baby teeth, alternative codes like D2385 or stainless steel crown codes would be more clinically appropriate based on the specific treatment needs.
What distinguishes D2390 from conventional lab-made crowns?
D2390 represents a chairside resin-based composite crown that dentists place directly during a single appointment. Traditional laboratory-fabricated crowns like porcelain or ceramic require taking impressions, laboratory work, and typically multiple patient visits. D2390 offers an immediate, economical restoration option, particularly beneficial for younger patients or situations where conventional permanent crowns aren't practical.
Why might insurance companies reject D2390 claims?
Insurance denials for D2390 can occur due to inadequate clinical documentation, lack of demonstrated medical necessity, or when plans treat it as an alternative benefit with reduced reimbursement. Additional denial reasons include exceeding annual frequency limits or incorrectly submitting the code for posterior teeth, which violates D2390 usage guidelines.