D2790Crown - Full Cast High Noble Metal

What This Code Covers

D2790 covers a full cast crown made entirely of high noble metal (over 60% noble metals, with at least 40% gold). There is no porcelain overlay. This is the classic "gold crown" known for excellent durability, wear compatibility with opposing teeth, and minimal tooth removal during preparation. It is most commonly placed on posterior teeth where esthetics are less of a concern.

Billing Guide

Bill this code when:

• A full metal crown with no porcelain is fabricated from high noble alloy
• The alloy contains over 60% noble metals with at least 40% gold
• The crown is cemented as a single-tooth restoration, typically on a molar

Do not bill this code when:

• The crown has a porcelain outer layer. Use D2750
• The metal is noble or base metal. Use the corresponding code
• The crown is all-ceramic. Use D2740
• The crown is a bridge retainer. Use D6790

Insurance and Denial Prevention

Key Payer Rules:

• Most plans cover D2790 at the standard crown benefit (typically 50%)
• Some plans may apply alternate benefits and pay at a lower metal rate
• Crown replacement frequency limits apply (5-10 years)
• Patient consent for a metal crown should be documented

Common Denials and How to Respond:

• Alternate benefit applied → Some plans pay all crowns at the base metal or PFM rate. The patient pays the difference.
• Crown not necessary → Submit documentation showing the tooth requires a crown restoration.
• Esthetic concerns → If the payer questions why a PFM or ceramic crown was not chosen, document the clinical rationale for a full metal crown.