Guide to D2750 Dental Code and Crowns

What ADA CDT dental code is D2750?

D2750 is the ADA CDT dental code for a porcelain-fused-to-metal (PFM) crown/cap on a tooth. It is used when the crown is made of ceramic or porcelain on the outside, and a high noble metal on the inside (i.e. a high content of precious metal). The code description is officially “crown – porcelain fused to high noble metal.”

Frequently Asked Questions About D2750 Dental Code

What procedure does D2750 refer to?

The dental code D2750 refers to the procedure for placing a crown made of porcelain fused to high noble metal. This type of crown is used to cover a damaged or decayed tooth, restoring its shape, size, strength, and appearance. The porcelain exterior provides a natural tooth-like appearance, while the high noble metal substructure offers strength and durability.

What are the documentation requirements and best practices for D2750?

  • Detailed clinical notes describing the condition of the tooth and the necessity for a crown.
  • Preoperative and postoperative radiographs to document the extent of damage and the placement of the crown.
  • A narrative explaining the necessity of the crown, including patient consent forms.
  • Impressions or digital scans used for fabricating the crown.

What are the typical reimbursement rates and guidelines for D2750?

Reimbursement rates for D2750 can vary depending on the insurance plan and geographic location. Typically, insurance may cover 50-80% of the procedure cost, with average reimbursement rates ranging from $800 to $1,500. It is important to verify specific insurance guidelines and negotiate rates if necessary.

Are there any common errors or pitfalls to avoid with D2750?

  • Ensure accurate documentation that clearly supports the necessity of the procedure.
  • Avoid coding errors such as using D2750 for crowns made of materials other than porcelain fused to high noble metal.
  • Double-check the patient’s dental history and radiographs to justify the procedure.

How should D2750 be submitted on an insurance claim, and what modifiers are required?

  • Include the correct tooth number and any supporting documentation.
  • Typically, no additional modifiers are required for D2750, but always verify with the specific insurance payer.
  • Ensure the claim form is filled out completely and accurately to avoid delays.

Is D2750 often used with other codes, and how does it fit into the overall coding system?

D2750 is often used in conjunction with other procedure codes as part of a comprehensive treatment plan. For example, it may be preceded by procedures like core buildups (D2950) or root canal treatments (D3310, D3320, D3330). Understanding its place within the overall coding system helps in accurate treatment planning and billing.

How can I verify patient eligibility and coverage for this procedure?

  • Use electronic verification tools provided by most insurance companies.
  • Call the insurance provider directly to confirm coverage specifics.
  • Check for any waiting periods, annual maximums, and frequency limitations that may apply to crown placements.

What are the ethical considerations and common fraud indicators associated with D2750?

  • Only use D2750 when a porcelain fused to high noble metal crown is clinically necessary and justified by the patient’s condition.
  • Be transparent with patients about their treatment needs and costs.
  • Watch for red flags such as patterns of excessive crown placements or inconsistent clinical documentation, which may indicate fraudulent activity.

What are the key differences between similar codes?

  • D2740: Crown, porcelain/ceramic substrate. Used for all-ceramic crowns without a metal substructure.
  • D2751: Crown, porcelain fused to predominantly base metal. Similar to D2750 but uses a different metal type.
  • D2752: Crown, porcelain fused to noble metal. Used for crowns with a noble metal substructure, different from high noble metal.

Why was D2750 specifically used for my treatment, and are there alternative treatments with different codes and costs?

D2750 was selected because your tooth required a crown with both aesthetic and durable qualities, provided by the porcelain exterior and high noble metal substructure. Alternative treatments might include:

  • D2740: For an all-ceramic crown if a metal-free option is preferred.
  • D2950: Core buildup, including any pins, if the tooth requires additional support before crown placement.
  • D2391: Resin-based composite filling for minor restorations that do not require a crown.
  • Discussing these options with your dentist will help in understanding the best course of action for your specific case.

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