Understanding Dental Code D2928

When to Use D2928 dental code

The D2928 dental code is designated for a prefabricated porcelain/ceramic crown on a permanent tooth. This CDT code is used when a permanent tooth requires a full-coverage restoration, but the clinical situation does not warrant a custom-fabricated crown. Instead, a prefabricated crown made of porcelain or ceramic is selected, adjusted, and cemented in a single visit. Common indications include interim coverage for fractured teeth, pediatric patients with permanent teeth, or as a cost-effective solution when a custom crown is not feasible.

Documentation and Clinical Scenarios

Accurate documentation is crucial for successful reimbursement of D2928. The clinical notes should clearly state:

• The reason for crown placement (e.g., fracture, extensive caries, failed restoration).
• Why a prefabricated porcelain/ceramic crown was chosen over other options (such as custom crowns or prefabricated stainless steel crowns).
• Details of the tooth preparation, crown selection, adjustment, and cementation process.
• Pre- and post-operative radiographs or intraoral images, if available, to support the clinical necessity.

Example scenarios include a teenager with a fractured anterior permanent tooth where a custom crown is delayed, or an adult patient requiring a temporary yet esthetic solution.

Insurance Billing Tips

When billing D2928, follow these best practices to maximize claim acceptance and minimize delays:

• Verify coverage: Not all dental plans cover prefabricated porcelain/ceramic crowns. Confirm benefits and frequency limitations before treatment.
• Submit detailed narratives: Include a concise explanation of medical necessity and why a prefabricated crown was selected. Attach supporting documentation (radiographs, photos, chart notes).
• Use correct CDT code: Ensure you are not confusing D2928 with codes for custom crowns (such as D2740 for porcelain/ceramic crowns) or prefabricated stainless steel crowns (D2930).
• Monitor EOBs: Review Explanation of Benefits for denial reasons. If denied, file a claim appeal with additional documentation and a detailed narrative.
• Track AR: Follow up on outstanding claims regularly to ensure timely payment and reduce accounts receivable aging.

Example Case for D2928

Case: A 15-year-old patient presents with a fractured maxillary central incisor (tooth #9) following trauma. The tooth is permanent, and the fracture extends into the incisal third. The dentist determines that a custom crown is not immediately appropriate due to ongoing growth and financial considerations. A prefabricated porcelain crown is selected, adjusted chairside, and cemented in place. The clinical notes detail the fracture, rationale for crown selection, and the procedure steps. Radiographs and intraoral photos are included in the claim submission. Insurance is verified beforehand, and a thorough narrative is provided. The claim is approved, and payment is received without delay.

This example highlights the importance of clinical documentation, insurance verification, and clear communication with payers when using D2928.