When is D2990 used?
The D2990 dental code, officially designated as "Resin infiltration of incipient smooth surface lesions", represents an important tool in the CDT code system for conservative caries treatment. Understanding proper application of D2990 enables dental offices to deliver superior patient treatment while maintaining correct insurance billing practices. This overview explains the appropriate usage of D2990, necessary record-keeping requirements, reimbursement strategies, and real-world applications to help your practice effectively implement this code.
When is D2990 used?
D2990 applies to resin infiltration procedures targeting early, non-cavitated decay (initial lesions) on smooth tooth surfaces, primarily in enamel. This treatment is appropriate when decay is detectable through radiographs or clinical examination, yet has not advanced to full cavitation. The objective is to stop lesion advancement without conventional drilling or restoration placement.
Primary requirements for D2990 application:
Decay limited to enamel or superficial dentin layers.
Absence of cavitation or structural tooth loss.
Lesion located on smooth surfaces (excluding occlusal or pit/fissure areas).
Resin infiltration performed to prevent caries advancement.
Avoid D2990 for decay requiring conventional fillings (refer to anterior composite restorations) or preventive sealant applications (sealant code D1351).
D2990 Charting and Clinical Use
Proper record-keeping is crucial for claim acceptance and regulatory compliance. Recommended practices include:
Clinical records: Thoroughly document treated teeth, lesion locations, and clinical reasoning for resin infiltration therapy.
Diagnostic imaging: Include radiographs or clinical photographs demonstrating initial lesions prior to intervention.
Treatment specifications: Record materials utilized, procedural steps completed, and patient authorization obtained.
Treatment results: Document anticipated outcomes (lesion stabilization, prevented cavitation).
Typical clinical applications involve white spot formations following orthodontic therapy, early smooth surface decay in young or adult patients, and circumstances where conventional restoration is premature.
Billing and Insurance Considerations
Insurance acceptance for D2990 dental code differs significantly among carriers. Consider these strategies to improve reimbursement success:
Coverage verification: Confirm patient plan benefits for D2990 before treatment initiation. Many insurers classify this as preventive or supportive care.
Prior approval: Submit pre-treatment authorization requests with comprehensive documentation (imaging, clinical notes) to minimize rejection risks.
Claims processing: Apply appropriate CDT code (D2990) with complete supporting materials. Provide clear medical necessity explanations in claim narratives.
Denial responses: When claims are rejected, submit appeals with enhanced clinical rationale and supporting research on resin infiltration effectiveness.
Patient education: Advise patients regarding potential personal costs when insurance excludes D2990 coverage.
Monitor carrier policy updates, as reimbursement for conservative caries interventions continues developing.
How dental practices use D2990
Clinical situation: A 15-year-old patient exhibits white spot formations on facial surfaces of maxillary front teeth after orthodontic appliance removal. Radiographic examination reveals initial enamel lesions without structural breakdown.
Treatment protocol:
Verify insurance benefits and secure pre-treatment authorization for D2990.
Record clinical observations and obtain diagnostic photographs.
Complete resin infiltration treatment following product guidelines.
Process claim with comprehensive narrative and supporting images.
Monitor claim progress and initiate appeals when needed.
This methodology illustrates clinical appropriateness, complete documentation, and strategic billing practices—essential elements for successful D2990 reimbursement.
Common Questions
Can the D2990 dental code be applied to both baby teeth and adult teeth?
The D2990 code is appropriate for use on both primary (baby) teeth and permanent (adult) teeth. The determining factor is not the tooth type, but rather that the treatment involves resin infiltration for early-stage, non-cavitated smooth surface lesions where the enamel remains intact.
What should dental offices do when insurance doesn't provide coverage for D2990?
When insurance coverage is not available for D2990, dental offices should provide transparent communication with patients prior to beginning treatment. This includes presenting a comprehensive cost estimate and exploring various payment alternatives. Offices might also consider implementing payment plan options or offering reduced rates for preventive treatments to make the procedure more financially accessible.
What conditions or patient circumstances make D2990 treatment unsuitable?
The D2990 procedure is not recommended for lesions that have already formed cavities or for patients with inadequate oral hygiene practices who face elevated risk of continued tooth decay. The treatment is also inappropriate when there are signs of dentin involvement beneath the surface or when patients are unable to commit to proper follow-up appointments and ongoing care.