Billing Guide for D2928 - PREFABRICATED PORCELAIN/CERAMIC CROWN - PERMANENT TOOTH
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 07, 2025
D2928 - PREFABRICATED PORCELAIN/CERAMIC CROWN - PERMANENT TOOTH
WARNING
1. D2928 does not report a custom crown. It must be a stock, prefabricated porcelain crown which is adjusted to fit.
2. Reports a permanent tooth prefabricated ceramic crown, not for a primary tooth. See D2929 for a primary tooth, prefabricated porcelain/ceramic crown.
COMMENTS
1. Prefabricated porcelain/ceramic crown (D2928) reports a porcelain/ceramic crown for an anterior or posterior permanent tooth.
2. Prefabricated porcelain crowns may be purchased pre-made, or instead milled or 3D printed based on a generic crown form using materials with greater than 50% inorganic fillers.
3. Enter the tooth number being treated in Box 27 of the 2024 ADA Dental Claim Form.
LIMITATIONS
D2928 may have a 5 year replacement clause or with some plans up to a 10 year replacement clause. The exclusions/limitations for this code are variable among payors.
TIPS
1. A core buildup (D2950), if necessary for the retention of a prefabricated porcelain/ceramic crown (permanent tooth), may be possibly reimbursed. See D2950.
2. 3D printed prefabricated restorations may be reported as porcelain/ceramic provided the material is greater than 50% inorganic filler.
NARRATIVES
Documentation should include why the crown is necessary. Document the extent of decay, any fractured and missing cusps and % of remaining tooth structure. Use of an intraoral camera is highly recommend to prove necessity of the permanent crown. A pre-op radiograph should also be included as supporting documentation.
WARNING
1. D2928 does not report a custom crown. It must be a stock, prefabricated porcelain crown which is adjusted to fit.
2. Reports a permanent tooth prefabricated ceramic crown, not for a primary tooth. See D2929 for a primary tooth, prefabricated porcelain/ceramic crown.
COMMENTS
1. Prefabricated porcelain/ceramic crown (D2928) reports a porcelain/ceramic crown for an anterior or posterior permanent tooth.
2. Prefabricated porcelain crowns may be purchased pre-made, or instead milled or 3D printed based on a generic crown form using materials with greater than 50% inorganic fillers.
3. Enter the tooth number being treated in Box 27 of the 2024 ADA Dental Claim Form.
LIMITATIONS
D2928 may have a 5 year replacement clause or with some plans up to a 10 year replacement clause. The exclusions/limitations for this code are variable among payors.
TIPS
1. A core buildup (D2950), if necessary for the retention of a prefabricated porcelain/ceramic crown (permanent tooth), may be possibly reimbursed. See D2950.
2. 3D printed prefabricated restorations may be reported as porcelain/ceramic provided the material is greater than 50% inorganic filler.
NARRATIVES
Documentation should include why the crown is necessary. Document the extent of decay, any fractured and missing cusps and % of remaining tooth structure. Use of an intraoral camera is highly recommend to prove necessity of the permanent crown. A pre-op radiograph should also be included as supporting documentation.
