Alloy

In dental restorations, alloys are categorized into three tiers based on their noble metal content: high noble (at least 60% noble metal, with a minimum of 40% gold), noble (at least 25% noble metal), and predominantly base metal (less than 25% noble metal). These classifications are not just clinical distinctions. They directly influence CDT code selection for crowns, bridges, inlays, and onlays. Each alloy tier has its own set of procedure codes, and billing the wrong tier is a common source of claim rejections.

For billing and collections teams, alloy selection affects both the cost of the restoration and the reimbursement the practice receives. High noble alloys carry a higher lab fee, which means the practice's overhead is greater. If the insurance plan only covers the base metal alternative, the patient may be responsible for the difference in cost. Practices must clearly communicate these material upgrade fees to patients before treatment and document the alloy type in the clinical record.

Accurate documentation of alloy composition is essential for clean claim submission. The dental lab should provide a certificate specifying the alloy type and noble metal percentages for every indirect restoration. Practices that fail to retain these records risk compliance issues during audits. Additionally, some payers require the alloy classification to be noted on the claim form, making it critical that front office teams understand the billing implications of alloy selection.