Billing Guide for D2722 - CROWN - RESIN WITH NOBLE METAL
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
D2722 - CROWN - RESIN WITH NOBLE METAL
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" (lab-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, Finesse, Cerinate", and Opc®.
COMMENTS
1. D2722 is used to report a noble metal crown coated with materials such as Cristobel®, Artglass®, Fibrecor, Targis, Vectris®, Concept, and Belleglass. The payor's fee may be lower for an indirect resin-based composite coating than for porcelain/ceramic coated restorations.
2. The code used to report the restoration should properly reflect the material (resin with noble metal) 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.
3. 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.
NARRATIVES
IMPORTANT! - See D2710 for crown narrative recommendations and Author's Comments prior to D2710.
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" (lab-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, Finesse, Cerinate", and Opc®.
COMMENTS
1. D2722 is used to report a noble metal crown coated with materials such as Cristobel®, Artglass®, Fibrecor, Targis, Vectris®, Concept, and Belleglass. The payor's fee may be lower for an indirect resin-based composite coating than for porcelain/ceramic coated restorations.
2. The code used to report the restoration should properly reflect the material (resin with noble metal) 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.
3. 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.
NARRATIVES
IMPORTANT! - See D2710 for crown narrative recommendations and Author's Comments prior to D2710.
