Understanding Dental Code D2750

When to Use D2750 dental code

The D2750 dental code is designated for a crown procedure: specifically, a crown made of porcelain fused to high noble metal. This CDT code should be used when a tooth requires full coverage due to extensive decay, fracture, or after root canal therapy, and when a porcelain-fused-to-metal (PFM) crown is the material of choice. It is not appropriate for all-ceramic or all-metal crowns—those have their own unique codes. Always verify the clinical need for a crown and ensure the material matches the code description before proceeding with billing.

Documentation and Clinical Scenarios

Proper documentation is essential for successful reimbursement. When using D2750, include detailed clinical notes describing the reason for the crown (e.g., large existing restoration, fracture lines, or endodontic treatment). Radiographs showing the extent of decay or previous restorations, intraoral photos, and charting should be attached to the claim. Common clinical scenarios include:

• Tooth with a failing large amalgam or composite filling
• Tooth with a fracture or crack that compromises its structure
• Tooth that has undergone root canal therapy and needs full coverage

Ensure that all supporting documentation is clear and legible, as this helps reduce claim denials and supports the medical necessity of the procedure.

Insurance Billing Tips

To maximize reimbursement and minimize delays, follow these best practices:

• Pre-authorization: Submit a pre-authorization request to the patient’s insurance with all supporting documents. This helps determine coverage and patient responsibility upfront.
• Verify frequency limitations: Many plans only cover crowns every 5–7 years per tooth. Check the patient’s insurance history to avoid denials due to frequency limitations.
• Use accurate narratives: In the claim narrative, clearly state the clinical justification for the crown and reference attached documentation.
• Coordination of benefits: If the patient has dual coverage, ensure proper coordination to maximize reimbursement and avoid overpayments.
• Appeal denied claims: If a claim is denied, review the EOB for the reason, gather any missing documentation, and submit a timely appeal with a detailed explanation and additional evidence.

Staying proactive with insurance verification and thorough documentation can significantly improve your practice’s AR and reduce the administrative burden on your team.

Example Case for D2750

Case: A 52-year-old patient presents with a fractured upper right first molar (tooth #3) with a large, failing amalgam restoration. After clinical evaluation and radiographs, the dentist determines a PFM crown is required for full coverage and long-term stability.

Billing workflow:

1. Verify the patient’s insurance benefits and frequency limitations for crowns.
2. Document the clinical findings, including intraoral photos and radiographs.
3. Submit a pre-authorization with all supporting documentation.
4. Once approved, perform the crown procedure and submit the claim using D2750, attaching all relevant documentation and a clear narrative.
5. Monitor the claim status, review the EOB, and address any denials or requests for additional information promptly.

This step-by-step approach ensures accurate billing, maximizes reimbursement, and supports a smooth revenue cycle for your dental practice.