Understanding Dental Code D2930

When to Use D2930 dental code

The D2930 dental code is designated for a prefabricated stainless steel crown—primary tooth. This CDT code is used when a child’s primary (baby) tooth requires full coverage restoration due to extensive caries, fracture, or developmental defects, but the tooth is not a candidate for a custom-fabricated crown. Stainless steel crowns are a reliable, cost-effective solution for restoring function and protecting the tooth until it naturally exfoliates. Use D2930 only for primary teeth; for permanent teeth, refer to the appropriate code, such as D2750 for porcelain fused to metal crowns.

Documentation and Clinical Scenarios

Accurate documentation is critical for successful claim approval. When billing D2930, ensure the patient’s chart clearly shows:

• Diagnosis justifying the need for a full-coverage restoration (e.g., extensive decay, large existing filling, fracture).
• Tooth number and surface(s) involved.
• Pre-operative radiographs or intraoral photos supporting the clinical findings.
• Clinical notes describing why a stainless steel crown was chosen over other restorative options.

Common clinical scenarios include pediatric patients with multi-surface caries on molars, teeth with pulpotomies, or those at high risk for further decay. Always document failed previous restorations or situations where a filling would not provide long-term success.

Insurance Billing Tips

To maximize reimbursement and minimize denials for D2930, follow these best practices:

• Verify insurance coverage before treatment—many plans cover stainless steel crowns for primary teeth, but age and frequency limitations may apply.
• Submit supporting documentation with the initial claim, including clinical notes, diagnostic images, and a narrative explaining the necessity.
• Use the correct tooth number and indicate that the tooth is primary (A-T or 1d-20d notation).
• If a claim is denied, review the Explanation of Benefits (EOB) for the reason and submit a claim appeal with additional documentation if needed.
• Track accounts receivable (AR) to ensure timely follow-up on outstanding claims.

Proactive communication with insurance representatives can help clarify coverage criteria and prevent unnecessary delays.

Example Case for D2930

Case: A 5-year-old patient presents with a large carious lesion on tooth S (primary mandibular right second molar). The decay involves multiple surfaces and a previous filling has failed. The dentist determines that a stainless steel crown is the best option for long-term protection.

Billing Steps:

1. Verify the patient’s insurance coverage for D2930 and note any age or frequency restrictions.
2. Document the diagnosis, clinical findings, and rationale for the crown in the patient’s chart.
3. Take pre-op radiographs and intraoral photos.
4. Submit the claim with D2930, attaching all supporting documentation and a clear narrative.
5. Monitor the claim status and follow up promptly if additional information is requested or if the claim is denied.

This approach ensures a higher likelihood of claim approval and proper reimbursement for the procedure.