Dental Code D2950 Definition

There has been a lot of confusion surrounding the meaning and use of dental code d2950. Therefore, it is important to shed more light on the meaning of the dental terminology and how it needs to be used. According to its description in CDT 2014, d2950 “refers to building up of coronal structure when there is insufficient retention for a separate extra coronal restorative procedure”. The dental code d2950 applies primarily to circumstances where enough of the tooth is missing for it to be unable to support a crown. In most cases, once 60% or more of the tooth is missing, it is considered liable for the application of the d2950 dental procedure code. It is important to make this distinction because insurance companies need a specific code and its application for the reimbursement procedure to take place. It is also important to consider that if the procedure is performed within the same day as a root canal procedure, the reimbursement for dental code D2950 cannot be performed.

In What Cases Do Insurance Companies Refuse To Reimburse?

Given the extent of confusion surrounding the definition, application and use of the code, it is important to outline the different set of circumstances in which insurers and insurance companies refuse to reimburse billing. The first of these, which has been mentioned above, is if a root canal procedure is performed on the same day as the performing of dental code D2950. Insurers will also refuse to reimburse if the preparation for a clean or ideal crown is part of the procedure. 

Insurance and reimbursement can also be denied in the case of the lack of a benefit narrative, which has to be procured from the dental office. Benefit narratives issued by the dental office are important because they provide a concise written statement explaining why such a procedure of this nature had to be performed. Every day, more and more carriers are coming to recognize the importance of dental narratives and the role that these play in helping us recognize dental procedures. More recently, it is increasingly recommended that companies produce dental narratives for different procedures to improve and optimize coverage and issues with cross-coding in the dental code. 

What Is The Difference Between D2950 And D2949?

D2949 was a new code that was introduced in CDT 2014. This is one of the reasons why d2950 is often misused. The 2014 CDT descriptor referred to d2949 as involving the “placement of restorative material to yield a more ideal form, including elimination of undercuts”. Dental code d2949 is only instituted in case of the need for restorative material on the tooth, which has to be used for a reason apart from ensuring that a new crown stays on. As mentioned above, it is often mistaken with and thus incorrectly submitted as a d2950 buildup. This is why it is necessary to make the distinction between the two. 

Buildup Codes d2952 and d2954

For the purpose of clarification, it is important that we list down and describe other dental procedures of a similar nature too. For this purpose, we have chosen D2952 and D2954, both of which are buildup codes. This exercise helps achieve two practical benefits, the first of which is an understanding of what these codes are and secondly what makes them different from dental code d2950.

D2954, apart from the crown process, refers to prefabricated core and post. A procedure of such nature involves the use of core material, which is then used to construct an endodontic tooth. In the case of the need for reimbursement and any claims pertaining to it, it must be noted that a dental narrative must be provided. The dental narrative must contain details that endodontic treatment of the truth has taken place and that the tooth in question has 50 percent or less of its structure remaining. 

D2952 differs from d2950 in the sense that it involves cast post and core, in addition to the crown procedure. It involves the use of core material. Payments on d2950 and d2952 are often not carried out at the same time.

Conclusion

For better and accurate dental billing, it is crucial to know and understand the dental codes you’re using. You should be able to differentiate between them to be able to prevent claim denials. Conclusively, d2950 dental code procedure involves placing a material on the tooth in case 60% or more of the tooth is missing and is unable to support a crown placement. In such a case the material filling will provide enough strength to support a crown and thus this service has to be performed prior to a crown procedure.

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