When is D2930 used?
The D2930 dental code applies to prefabricated stainless steel crown placement on primary teeth. This CDT code is utilized when a child's baby tooth needs complete coverage restoration because of significant decay, tooth breakage, or birth defects, yet the tooth doesn't qualify for a custom-made crown. Stainless steel crowns offer a dependable, budget-friendly approach for restoring tooth function and safeguarding the tooth until it falls out naturally. Apply D2930 exclusively for baby teeth; for adult teeth, use the correct code, such as D2750 for ceramic fused to metal crowns.
D2930 Charting and Clinical Use
Proper record-keeping is essential for claim acceptance. When submitting D2930, make sure the patient's records clearly include:
Medical diagnosis explaining why full-coverage restoration is needed (such as widespread decay, large current filling, breakage).
Specific tooth identification and affected area(s).
Before-treatment X-rays or mouth photographs confirming clinical observations.
Treatment notes explaining the reasoning behind selecting a stainless steel crown instead of other repair choices.
Typical treatment situations involve young patients with decay affecting multiple tooth surfaces on back teeth, teeth that have had pulpotomies, or those with high chances of additional decay. Always record unsuccessful prior treatments or cases where regular fillings wouldn't offer lasting results.
Billing and Insurance Considerations
To optimize payment and reduce claim rejections for D2930, implement these recommended practices:
Check insurance benefits prior to treatment—most policies cover stainless steel crowns for baby teeth, though patient age and treatment frequency restrictions may exist.
Include supporting materials with your first claim submission, such as treatment notes, diagnostic pictures, and written explanation of medical necessity.
Apply the proper tooth identification and specify that it's a primary tooth (A-T or 1d-20d system).
When claims get rejected, examine the Explanation of Benefits (EOB) for rejection reasons and file a claim reconsideration with extra documentation when appropriate.
Monitor outstanding payments to guarantee prompt follow-through on pending claims.
Early communication with insurance company staff helps clarify benefit requirements and avoid unnecessary processing delays.
How dental practices use D2930
Case: A 5-year-old child comes in with extensive tooth decay on tooth S (baby lower right second molar). The cavity affects several tooth surfaces and an earlier filling has broken down. The dental provider decides that a stainless steel crown offers the best long-term tooth protection.
Billing Steps:
Check the patient's dental insurance benefits for D2930 and record any age or treatment frequency limits.
Record the diagnosis, examination results, and crown recommendation reasoning in the patient's file.
Obtain before-treatment X-rays and clinical photographs.
Process the claim using D2930, including all supporting materials and detailed written explanation.
Track the claim progress and respond quickly if more information is needed or if the claim gets rejected.
This method improves the chances of claim acceptance and appropriate payment for the treatment.
Common Questions
What alternatives exist to stainless steel crowns for primary teeth beyond D2930 billing?
Alternative materials are available for primary teeth crowns, including zirconia and resin-based options. These alternatives utilize different procedure codes and may have varying insurance coverage policies compared to D2930, which is designated specifically for prefabricated stainless steel crowns on primary teeth.
Is D2930 appropriate for use on permanent teeth or adult patients?
D2930 is exclusively for primary (baby) teeth applications. Permanent teeth require different procedural codes based on the crown type and material used. Incorrectly applying D2930 to permanent teeth will lead to claim rejections and potential compliance violations.
What steps should dental practices take when a D2930 stainless steel crown fails before the insurance frequency limit expires?
When crown failure occurs before the frequency limitation period ends, practices must thoroughly document the clinical failure reasons and include this documentation with the replacement claim. While some insurers may approve exceptions for early replacement with proper clinical justification, approval cannot be guaranteed.