D2980Crown Repair, by Report

What This Code Covers

D2980 covers crown repair, by report. The existing crown is repaired in the mouth rather than replaced. Documentation should describe the nature of the defect and the repair method used.

Billing Guide

Bill this code when:

• A crown repair, by report 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 D2960 (Labial veneer (resin laminate) - chairside)

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.