Billing Guide for D2710 CROWN - RESIN-BASED COMPOSITE (INDIRECT)
Solutions
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Description
This is an optional lesson that covers advanced billing guidelines. It is not required but may be helpful for further learning.
May 06, 2025
D2710 - CROWN - RESIN-BASED COMPOSITE (INDIRECT)
1. It is misleading to report a crown placed on a natural tooth if the restoration is an abutment supported or implant supported crown.
2. It is misleading to report retainer crowns of a fixed bridge as single crowns in order to receive a higher reimbursement. (Single unit crowns may be reimbursed at 80% of the payor's fee whereas a retainer crown may be reimbursed at 50% of the payor's fee.)
3. It is misleading to report Cristobel®, Artglass®, Belleglass® and similar materials using the porcelain/ceramic codes, rather than the "indirect" (laboratory processed) or CAD/CAM-resin-based composite codes. Cristobel®, Artglass®, and Belleglass® are considered laboratory processed indirect resin-based composites, not porcelain/ceramics. Porcelain materials could include Vita, ProCad", Empress, Lava Ultimate", Procera, InCeram®, Lava, Finesse, Cerinate®, and Opc®. 3D printed restorations may be reported as porcelain/ceramic provided the material is greater than 50% inorganic filler.
4. Do not report D2710 for use as a long term provisional crown. D2710 is a definitive restoration. See D2799.
COMMENTS
1. D2710 is used to report Cristobel, Artglass", Fibrecor, Targis, Vectris®, Concept, and Belleglass® type restorations. Resin-based composite restorations may be laboratory fabricated, milled, or 3D printed using the appropriate materials. The payor's fee is often lower for an indirect resin-based composite than for porcelain/ceramic restorations.
2. Enter the tooth number being treated in Box 27 of the 2024 ADA Dental Claim Form.
LIMITATIONS
1. Most payors have an age limitation exclusion. They will not reimburse a permanent crown unless the patient is at least 12-13 years old. If the patient is under 18, always determine if there is an age used exclusion before starting treatment. Consider a large filling plus D2976 band stabilization as an alternative procedure. See D2976.
2. Crown replacement may be limited by the plan and can vary from five to 10 years after the prior placement. The trend is moving toward 10 years. Trauma requiring a new crown may override this replacement exclusion.
TIPS
1. The code used to report the restoration should properly reflect the material (resin) used for the restoration. The material used should be the same as recorded in the treatment plan, clinical note, on the lab slip, and the insurance claim form.
2. D2710 would also be used to report a resin-based CAD/CAM crown when using a resin block to mill the restoration.
NARRATIVES
1. When submitting a crown claim it is essential that a narrative be included to avoid delays and/or claim denials. The narrative should address the existence of caries or other pathology, condition and size of prior restoration, and the condition of the remaining tooth structure. Make note of any undermined, fractured or missing cusps and any symptoms the patient may be experiencing with the affected tooth.
2. If treating cracked tooth syndrome, indicate how the diagnosis was made, e.g., MF cusp positive.to Tooth Slooth™.
3. Include pre-operative radiographs AND intraoral photos demonstrating pathology necessitating the crown restoration, if applicable. If the tooth has RCT, send a PA as well.
4. List any missing cusps.
5. State the estimated percentage of healthy tooth structure left after fracture, caries and/or any previous restoration is removed.
6. State if tooth has existing or planned RCT (root canal therapy).
7. State if tooth has circumferential decay and amount of decay, e.g., circumferential decay on M, L and D encompassing 270 degrees of tooth.
8. State endodontic and periodontal prognosis for tooth.
9. If this is a replacement crown, state date that the previous crown was seated.
10. If replacing an existing crown, state reason for replacement, e.g., tooth has caries, margins are open, porcelain is fractured off, poor contacts are causing food impactions, etc.
1. It is misleading to report a crown placed on a natural tooth if the restoration is an abutment supported or implant supported crown.
2. It is misleading to report retainer crowns of a fixed bridge as single crowns in order to receive a higher reimbursement. (Single unit crowns may be reimbursed at 80% of the payor's fee whereas a retainer crown may be reimbursed at 50% of the payor's fee.)
3. It is misleading to report Cristobel®, Artglass®, Belleglass® and similar materials using the porcelain/ceramic codes, rather than the "indirect" (laboratory processed) or CAD/CAM-resin-based composite codes. Cristobel®, Artglass®, and Belleglass® are considered laboratory processed indirect resin-based composites, not porcelain/ceramics. Porcelain materials could include Vita, ProCad", Empress, Lava Ultimate", Procera, InCeram®, Lava, Finesse, Cerinate®, and Opc®. 3D printed restorations may be reported as porcelain/ceramic provided the material is greater than 50% inorganic filler.
4. Do not report D2710 for use as a long term provisional crown. D2710 is a definitive restoration. See D2799.
COMMENTS
1. D2710 is used to report Cristobel, Artglass", Fibrecor, Targis, Vectris®, Concept, and Belleglass® type restorations. Resin-based composite restorations may be laboratory fabricated, milled, or 3D printed using the appropriate materials. The payor's fee is often lower for an indirect resin-based composite than for porcelain/ceramic restorations.
2. Enter the tooth number being treated in Box 27 of the 2024 ADA Dental Claim Form.
LIMITATIONS
1. Most payors have an age limitation exclusion. They will not reimburse a permanent crown unless the patient is at least 12-13 years old. If the patient is under 18, always determine if there is an age used exclusion before starting treatment. Consider a large filling plus D2976 band stabilization as an alternative procedure. See D2976.
2. Crown replacement may be limited by the plan and can vary from five to 10 years after the prior placement. The trend is moving toward 10 years. Trauma requiring a new crown may override this replacement exclusion.
TIPS
1. The code used to report the restoration should properly reflect the material (resin) used for the restoration. The material used should be the same as recorded in the treatment plan, clinical note, on the lab slip, and the insurance claim form.
2. D2710 would also be used to report a resin-based CAD/CAM crown when using a resin block to mill the restoration.
NARRATIVES
1. When submitting a crown claim it is essential that a narrative be included to avoid delays and/or claim denials. The narrative should address the existence of caries or other pathology, condition and size of prior restoration, and the condition of the remaining tooth structure. Make note of any undermined, fractured or missing cusps and any symptoms the patient may be experiencing with the affected tooth.
2. If treating cracked tooth syndrome, indicate how the diagnosis was made, e.g., MF cusp positive.to Tooth Slooth™.
3. Include pre-operative radiographs AND intraoral photos demonstrating pathology necessitating the crown restoration, if applicable. If the tooth has RCT, send a PA as well.
4. List any missing cusps.
5. State the estimated percentage of healthy tooth structure left after fracture, caries and/or any previous restoration is removed.
6. State if tooth has existing or planned RCT (root canal therapy).
7. State if tooth has circumferential decay and amount of decay, e.g., circumferential decay on M, L and D encompassing 270 degrees of tooth.
8. State endodontic and periodontal prognosis for tooth.
9. If this is a replacement crown, state date that the previous crown was seated.
10. If replacing an existing crown, state reason for replacement, e.g., tooth has caries, margins are open, porcelain is fractured off, poor contacts are causing food impactions, etc.
