When is D2931 used?
The D2931 dental code applies to prefabricated stainless steel crowns for permanent teeth. This CDT code finds frequent application in pediatric dental practices but also serves adult patients requiring durable temporary restorations on permanent teeth. D2931 becomes suitable when teeth present with significant decay, structural defects from development, or following pulpotomy/pulpectomy procedures where complete coverage restoration is needed but custom crowning isn't immediately warranted. These steel crowns work best on back teeth because of their durability and economic value.
D2931 Charting and Clinical Use
Proper record-keeping remains critical for claim approval and payment processing. Patient records must clearly document:
Specific tooth identification and affected surfaces
Clinical diagnosis (such as decay, breaks, or growth irregularities)
Justification for selecting prefabricated crowns versus alternative treatments
Information about previous treatments like pulpotomy or pulpectomy
Before and after X-rays when obtainable
Typical clinical applications for D2931 involve children's first adult molars with significant damage, or adult molars needing temporary full protection for financial or treatment reasons. Patient files should always contain solid reasoning for choosing stainless steel crown placement.
Billing and Insurance Considerations
For optimal payment outcomes and reduced claim rejections when submitting D2931:
Check coverage details prior to treatment to verify stainless steel crown benefits for permanent teeth, since certain policies limit this coverage to baby teeth only (D2930).
Include comprehensive explanations with claims describing medical necessity and reasons other treatments weren't appropriate.
Include supporting materials like clinical photographs and X-ray images showing damage severity.
Carefully examine benefit statements after submission. For denials, verify policy restrictions or missing information, then file appeals with supplementary evidence when appropriate.
Monitor submitted claims through your billing system to maintain prompt follow-up and resolution.
Success with D2931 billing depends on thorough benefit verification and complete documentation practices.
How dental practices use D2931
Case: A 9-year-old child arrives with severe decay affecting the lower first adult molar (tooth #19). Following decay removal and pulpotomy treatment, remaining tooth structure proves inadequate for standard filling placement. The dentist applies a prefabricated stainless steel crown to provide complete protection and longevity.
Recommended Practice Steps:
Record the diagnosis, treatment, and crown selection reasoning in patient charts.
Capture before and after X-rays plus clinical photographs.
Confirm insurance benefits for D2931 before starting treatment.
File claims including detailed explanations and all supporting evidence.
Track claim progress and address any information requests or appeal needs quickly.
Following these steps promotes clear insurer communication and helps practices achieve better payment outcomes.
Common Questions
Do insurance plans reimburse D2931 at the same rate for both primary and permanent teeth?
No, reimbursement rates for D2931 typically differ based on whether the stainless steel crown is placed on a primary or permanent tooth. Most insurance plans provide better coverage for D2931 on primary teeth, particularly for pediatric patients, while offering limited or no coverage for permanent teeth. It's essential to confirm coverage specifics with the patient's insurance carrier prior to beginning treatment.
Is it possible to bill D2931 together with other dental procedures like pulpotomy or space maintainers?
Yes, D2931 can be submitted alongside other necessary procedures such as pulpotomy (D3220 or D3221) when clinically appropriate. However, insurance companies may review claims more carefully when multiple procedures are performed on the same tooth, making thorough documentation and separate procedure narratives crucial. When space maintainers are also required, they should be coded separately with proper documentation explaining why both treatments are necessary.
What should dental practices do when a stainless steel crown (D2931) requires replacement before its expected duration?
When a D2931 crown fails prematurely or requires early replacement, comprehensive documentation of the failure reason is essential (such as additional decay, crown displacement, or dental trauma). Many insurance policies have frequency restrictions and may deny coverage for replacements within specific timeframes (typically 2-5 years). For these situations, submit comprehensive documentation along with a detailed narrative justifying the medical necessity for early crown replacement when processing the claim or filing an appeal.