D2792Crown - Full Cast Noble Metal

What This Code Covers

D2792 covers crown - full cast noble metal. The tooth is prepared, an impression is taken, and the restoration is fabricated to precise specifications before cementation. Material selection affects both the code used and the expected reimbursement level.

Billing Guide

Bill this code when:

• A crown - full cast noble metal is delivered and cemented on a prepared tooth
• The material and fabrication method match the code description
• The tooth preparation, impression, and delivery are documented

Do not bill this code when:

• The material or metal type does not match this code description
• The restoration is on an implant abutment rather than a natural tooth. Use the appropriate D6xxx implant crown code
• Only a temporary crown is placed. Use D2799 for a provisional crown
• The procedure is better described by D2780 (Crown - 3/4 cast high noble metal)

Insurance and Denial Prevention

Key Payer Rules:

• Most plans cover restorative procedures at 50-80% depending on the specific service
• Downgrades may apply (e.g., porcelain crown downgraded to base metal on posterior teeth)
• Waiting periods often apply for major restorative services on new plans
• Some plans require prior authorization for crowns and indirect restorations

Common Denials and How to Respond:

• Material downgrade - The payer covers an alternate material at a lower fee. Bill the actual code and let the patient know about the potential balance.
• Waiting period not met - Verify the patient's plan effective date and any waiting periods for major services.
• Tooth not restorable - Submit radiographs and clinical documentation showing the tooth can be successfully restored.