Alyssa Lane
Zirconia crowns are a type of dental crown, which are partially covered by insurance, but not for cosmetic reasons. Dental insurance covers crowns when they are medically necessary, such as in the case of a weak or cracked tooth. The coverage for a crown is usually 50% of the cost of the procedure, with the patient liable for the rest.
Zirconia crowns are a newer type of dental crown, made from a white metal covered in porcelain. They are stronger than porcelain fused to metal (PFM) crowns and are prescribed when high strength is preferred. Zirconia crowns are also used for aesthetically pleasing bridges.
When billing for zirconia crowns, the correct code to use is D2750 crown—porcelain/ceramic substrate. This code is the same for both zirconia and e-max crowns, which are both types of porcelain crowns. It is important to use the correct codes when billing insurance to ensure accurate reimbursement.
To bill PPO insurance for a zirconia crown, the correct dates for the different stages of the procedure must be submitted. The prep date is the final impression date of the tooth prepared for the crown, the seat date is when the crown is seated or delivered to the patient, and the completion date is when the service is completed. For in-network dentists, the PPO contract will state that all services are to be submitted and will be benefited based on the completion date. For out-of-network dentists, the incurred liability date, which is the date the plan is legally liable to consider reimbursement, is important to determine if payment will be issued.
What You'll Learn
Zirconia crowns are billed under the code D2929
Zirconia crowns are a type of dental crown that uses zirconium, a strong and aesthetically pleasing material. Zirconia crowns are often chosen for their cosmetic and strength benefits. They are individually milled to a generic tooth preparation model.
Zirconia crowns are a relatively new procedure in the dentistry field. As such, insurance coverage for zirconia crowns can be difficult to obtain. However, the American Dental Association (ADA) has issued a specific code for zirconia crowns: D2929. This code is essential for insurance reimbursement and is used to record the exact service provided by the dentist.
The D2929 code is designated as a prefabricated porcelain/ceramic crown for primary teeth. It is important to note that this code only applies to zirconia crowns for primary teeth and not for custom-fabricated crowns. The code was established to address the increasing demand for esthetic anterior and posterior crowns.
When billing for zirconia crowns, it is crucial to use the correct code and follow the proper procedures. The role of the dental practice is to submit the most accurate code that describes the procedure. Using the correct code helps ensure proper reimbursement from insurance companies.
In conclusion, zirconia crowns are billed under the code D2929, which has been established by the ADA to facilitate insurance reimbursement for this specific type of dental crown. This code is an important step in ensuring that patients can access the benefits of zirconia crowns and that dental practices can provide the best possible service to their patients.
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The code for ceramic crowns is D2740
D2740 is used specifically when reporting ceramic, porcelain, or zirconia crowns. It is important to note that this code should only be used when reporting these types of crowns and not for other types of crowns, such as metal crowns. The cost of a D2740 crown procedure can vary depending on the plan chosen and the materials used.
Dental insurance companies will refer to the patient's plan limitations and exclusions when considering a dental claim for a crown. It is important to note that most PPO dental plans will reimburse for porcelain or ceramic crowns when placed in the anterior region of the mouth, often referred to as the "smile zone," but not when placed in the posterior region. Additionally, most PPO plans limit reimbursement for crown replacement to every 10 years, regardless of the material used.
When submitting a claim for a D2740 crown, it is important to include pre-op and post-op x-rays, as well as any other relevant documentation, such as a narrative describing the location of any tooth decay that is not visible on the x-rays.
The D2740 code is significant in the field of dentistry as it allows for precise communication between dental professionals, insurers, and patients. It is essential for billing and insurance claims, as it helps insurance companies determine coverage and process claims efficiently.
The code for molars is D2790 or D2792
It is important to use the correct codes when billing for dental procedures. The American Dental Association (ADA) publishes an annual reference manual of CDT codes, which are used by dentists, dental facilities, and insurance companies. Using the correct codes ensures accurate billing and reimbursement.
Dental billing codes are an essential aspect of the business side of dentistry. Accurate coding ensures compliance with insurance company requirements and helps to avoid issues such as delayed reimbursement or violation of PPO contract agreements.
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PPO contracts state that services are to be submitted and benefitted based on the completion date
Zirconia crowns are a new technology in the dental industry, and insurance coverage for them can be complex. The billing code for zirconia crowns is D2929, which was issued by the American Dental Association (ADA) in 2018. This code is specifically for prefabricated porcelain/ceramic crowns for primary teeth.
When billing PPO insurance for zirconia crowns, it is important to note that PPO contracts state that services are to be submitted and benefitted based on the completion date. This means that the date the service is completed, such as when the crown is seated or delivered to the patient, is the date that will be used for billing and reimbursement purposes. This is true for both in-network and out-of-network providers.
The completion date is important because it impacts the way the patient's benefits are used. If a service is submitted before the completion date, it may result in a legal issue for violation of a PPO contract agreement. Additionally, the ADA dental claim form indicates that procedures are either in progress or have been completed, and payers process claims through auto-adjudication, so the correct date must be provided to ensure accurate reimbursement.
It is also worth noting that the choice of material, such as zirconia or e.max, does not affect the billing code. The code D2750 crown—porcelain/ceramic substrate applies to both types of crowns. However, the cost of doing business changes with the material selected, and this can affect the fees charged to the patient.
To summarise, when billing PPO insurance for zirconia crowns, it is crucial to submit the claim based on the completion date of the service, as stated in the PPO contract. This ensures compliance with the contract and accurate reimbursement from the insurance company.
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The correct code for zirconia crowns is D2750
Zirconia crowns are a popular choice for dental patients due to their strength and durability. They are made from a type of ceramic called zirconium oxide, which is stronger than porcelain and some metal alloys. Zirconia crowns are also less likely to cause stress and damage to opposing teeth compared to porcelain crowns.
When it comes to billing for zirconia crowns, using the correct code is essential. The American Dental Association (ADA) has designated the code D2929 specifically for prefabricated zirconia crowns for primary teeth. This code was established to address the lack of a specific code for ceramic substrate materials in the CDT 2011-2012 coding system.
For zirconia crowns on anterior and posterior teeth, the correct code is D2750, as confirmed by coding expert Patti DiGangi. This code applies to both zirconia and e.max crowns, as both materials fall under the category of porcelain/ceramic substrate. It is important to note that the code remains the same regardless of the material used, and the cost of the procedure may vary depending on the material.
In the past, insurance companies did not typically cover all-ceramic crowns. However, certain insurance companies now provide coverage for all-ceramic crowns, including zirconia crowns. To determine if a patient's insurance covers zirconia crowns, it is necessary to contact their insurance carrier. If coverage is provided, the patient's dentist will need to submit an x-ray and a narrative explaining the medical necessity of the procedure.
It is worth noting that insurance coverage for zirconia crowns can vary by state and plan. Additionally, reimbursement rates for zirconia crowns may be lower than those for other types of crowns, such as stainless steel crowns.
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Frequently asked questions
Zirconia crowns are covered by dental insurance when they are medically necessary. If they are done for cosmetic reasons, they are not covered.
The billing code for zirconia crowns is D2929.
The date of billing depends on whether the dentist is in-network or out-of-network. For in-network dentists, the PPO contract includes a provision stating that all services are to be submitted and will be benefitted based on the completion date. For out-of-network dentists, the incurred liability date is the date a plan is legally liable to consider reimbursement.
