Billing Guide for D2712 CROWN - 3/4 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
D2712 - CROWN - 3/4 RESIN-BASED COMPOSITE (INDIRECT)
This procedure does not include facial veneers.
WARNING
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 a single crown(s) 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 codes. Cristobel, Artglass, and Belleglass are considered lab processed indirect resins, not porcelain/ceramics. Porcelain materials could include Vita®, ProCad®, Empress®, Procera, InCeram®, Lava, Lava Ultimate®, 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 D2712 for use as a long term provisional crown. D2712 is a definitive restoration. See D2799.
COMMENTS
1. % crown (D2712) 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 and surfaces being treated in the appropriate boxes 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, on the lab slip, and the insurance claim form.
2. D2712 would also be used to report a resin-based CAD/CAM crown when using a resin block to mill the restoration.
NARRATIVES
IMPORTANT! See D2710 for crown narrative recommendations and Author's Comments prior to D2710.
This procedure does not include facial veneers.
WARNING
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 a single crown(s) 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 codes. Cristobel, Artglass, and Belleglass are considered lab processed indirect resins, not porcelain/ceramics. Porcelain materials could include Vita®, ProCad®, Empress®, Procera, InCeram®, Lava, Lava Ultimate®, 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 D2712 for use as a long term provisional crown. D2712 is a definitive restoration. See D2799.
COMMENTS
1. % crown (D2712) 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 and surfaces being treated in the appropriate boxes 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, on the lab slip, and the insurance claim form.
2. D2712 would also be used to report a resin-based CAD/CAM crown when using a resin block to mill the restoration.
NARRATIVES
IMPORTANT! See D2710 for crown narrative recommendations and Author's Comments prior to D2710.
