When is D2928 used?
The D2928 dental code applies to prefabricated porcelain/ceramic crowns placed on permanent teeth. This CDT code is utilized when a permanent tooth needs complete coverage restoration, yet circumstances don't require a custom-made crown. A prefabricated porcelain or ceramic crown is chosen, modified, and bonded during one appointment. Typical uses include temporary protection for broken teeth, permanent teeth in pediatric patients, or as an economical alternative when custom crowns aren't practical.
D2928 Charting and Clinical Use
Proper documentation is essential for successful D2928 reimbursement. Clinical records must clearly include:
The indication for crown placement (such as tooth fracture, significant decay, or restoration failure).
Justification for selecting a prefabricated porcelain/ceramic crown instead of alternatives (like custom crowns or prefabricated metal crowns).
Complete details of tooth preparation, crown fitting, modifications, and cementation procedures.
Before and after radiographs or clinical photographs when available to demonstrate treatment necessity.
Common situations include an adolescent with a broken front permanent tooth awaiting a custom crown, or an adult needing an interim esthetic restoration.
Billing and Insurance Considerations
When submitting claims for D2928, implement these strategies to improve approval rates and reduce processing delays:
Check benefit coverage: Many dental insurance plans don't cover prefabricated porcelain/ceramic crowns. Verify patient benefits and annual limitations prior to treatment.
Provide comprehensive narratives: Include clear explanations of treatment necessity and rationale for prefabricated crown selection. Include supporting materials (X-rays, photographs, clinical notes).
Apply accurate CDT coding: Avoid mixing up D2928 with custom crown codes (like D2740 for porcelain/ceramic crowns) or prefabricated metal crowns (D2930).
Review benefit statements: Examine Explanation of Benefits for denial explanations. When claims are rejected, submit appeals with supplementary documentation and comprehensive narratives.
Monitor receivables: Consistently follow up on pending claims to ensure prompt payment and minimize aging accounts receivable.
How dental practices use D2928
Case: A 15-year-old patient arrives with a broken maxillary central incisor (tooth #9) after sports injury. The permanent tooth has a fracture reaching the incisal edge. The dentist decides a custom crown isn't immediately suitable due to continued facial development and cost factors. A prefabricated porcelain crown is chosen, modified in the operatory, and cemented. Clinical documentation includes fracture details, treatment rationale, and procedure notes. X-rays and clinical images accompany the insurance claim. Benefits are confirmed in advance, and a complete narrative is submitted. The claim receives approval and timely payment.
This case demonstrates the value of thorough clinical records, benefit verification, and effective insurance communication when billing D2928.
Common Questions
Is D2928 appropriate for pediatric patients or primary teeth?
D2928 is exclusively for prefabricated porcelain/ceramic crowns on permanent teeth only. For primary teeth, use alternative CDT codes like D2930 (prefabricated stainless steel crown – primary tooth) or D2934 (prefabricated esthetic crown – primary tooth). Always confirm the appropriate code based on tooth type and patient age.
What material restrictions apply to D2928 billing?
D2928 is strictly limited to prefabricated crowns manufactured from porcelain or ceramic materials only. This code cannot be used for prefabricated crowns made from other materials like metal or resin. Proper material selection is essential for accurate coding and successful insurance reimbursement.
How does D2928 reimbursement compare to custom crown fabrication?
D2928 typically receives lower reimbursement compared to custom-fabricated crowns like D2740 or D2750, as prefabricated options require reduced laboratory work and treatment time. Insurance coverage and payment amounts vary by plan, so always verify patient benefits and discuss potential costs prior to beginning treatment.