When is D2790 used?
The D2790 dental code applies to the placement of a complete cast high noble metal crown. This CDT code should be selected when a tooth needs full coverage protection due to significant decay, structural damage, or following root canal therapy, and when high noble metal materials (like gold or platinum alloys) are selected for their strength and biocompatibility. Apply D2790 exclusively when the clinical conditions warrant this treatment and the crown is made entirely from high noble metal materials, excluding porcelain-fused or base metal options. Correct code usage ensures proper reimbursement and adherence to insurance guidelines.
D2790 Charting and Clinical Use
Proper record-keeping is vital when submitting claims for D2790. Dental practices must verify that patient records contain:
Comprehensive clinical documentation describing decay extent, damage, or structural compromise
Pre-treatment radiographic images demonstrating tooth condition
Clinical photographs (when available) providing visual documentation
Material choice documentation confirming high noble metal use
Typical clinical applications include:
A posterior tooth with significant decay affecting cusp integrity
An endodontically treated tooth needing complete protection
Replacement of a failed high noble metal crown due to deterioration or secondary decay
Complete record-keeping validates treatment necessity and reduces claim rejection risks.
Billing and Insurance Considerations
For optimal reimbursement and reduced processing delays when submitting D2790 claims:
Confirm benefits: Prior to treatment, validate that the patient's insurance includes high noble metal crown coverage and review any frequency restrictions or replacement policies.
Include supporting materials: Always attach clinical documentation, radiographic images, and photographs with claims. Clearly specify high noble metal usage in treatment notes.
Apply correct coding: Avoid using D2790 in place of other crown procedures, such as porcelain-fused-to-metal restorations or full cast noble metal restorations. Every code has distinct requirements.
Review benefit statements: Examine Explanation of Benefits documents for payment discrepancies or rejections. When claims are denied, analyze the carrier's explanation and prepare appeals with supplementary documentation when needed.
Manage receivables: Maintain accounts receivable oversight by pursuing pending claims within 30 days of initial submission.
Effective payer communication and thorough documentation facilitate successful claim resolution.
How dental practices use D2790
Scenario: A 55-year-old patient arrives with a damaged maxillary right first molar (tooth #3) that previously received endodontic treatment. Clinical assessment and imaging reveal inadequate remaining structure for conservative restoration. The practitioner suggests a complete cast high noble metal crown for maximum durability and performance.
Processing steps:
Benefit verification establishes D2790 coverage with a five-year replacement limitation.
Pre-treatment images and clinical photographs are captured and included with the claim.
Treatment records document the structural damage and reasoning for high noble metal choice.
The claim is processed using D2790, complete documentation, and detailed treatment explanation.
Benefit statements are examined upon arrival. When additional details are needed, the practice responds quickly with necessary materials.
This systematic method improves claim acceptance rates and accelerates payment processing.
Common Questions
What qualifies as a high noble metal for D2790 dental crowns?
High noble metal for D2790 crowns refers to dental alloys containing a minimum of 60% noble metals (including gold, platinum, and palladium), with gold comprising at least 40% of the total composition. These premium metals are selected for their exceptional durability, outstanding corrosion resistance, and superior biocompatibility with oral tissues.
Is D2790 appropriate for use on primary teeth?
D2790 is generally not recommended for primary teeth due to the significant cost and extended lifespan of high noble metal crowns. For baby teeth, alternative codes like D2930 (stainless steel crown) are more appropriate and widely accepted by insurance providers.
What alternatives exist for patients who cannot afford high noble metal crowns?
Patients unable to afford high noble metal crowns have several alternatives available, including porcelain-fused-to-metal crowns (D2750) and all-ceramic crowns (D2740). Each option offers different characteristics and pricing, and the corresponding CDT code must be used for proper insurance claim processing.