Understanding Dental Code D2920 for Re-cementing or Re-bonding Crowns

Usually, dental care consists of numerous specialized procedures, each with its code used for documentation and billing. Such procedures are called CDT (Current Dental Terminology) codes and enable efficient communication between dental practitioners, insurance implications, and patients. D2920 is one such code that specifically refers to the removal and replacement of cement of a dental crown, a common simple procedure that takes care of the patient’s oral health and the longevity of restorative dental treatment. 

For better understanding, knowing what this particular code is about will not only help the dental practitioner but will also empower the patient to deal more intimately with his or her treatment plan and insurance coverage. This blog will elaborate on Dental Code D2920, what it is used for, what the procedure outlines, and why proper coding is important to bill paid and give quality care.

What Is Dental Code D2920?

D2920 refers to the procedure code for recementing a crown in a patient’s mouth, coming under the category of Current Dental Terminology (CDT). This coding is compliant with standardized procedures relating to reimbursement by the insurance scheme in billing patients for dental work. What does that mean? A broken crown-the way it is usually understood in terms of materials like porcelain or metal crowns or pure ceramics-the dentist does not mean that the patient shall have to get a new crown. It just means that the dentist may refer the patient for reattachment using recementation with clean and new cement and reattachment of the crown.

This code is effective whenever there is a possibility of repairing a crown rather than replacing it. This is not an uncommon procedure, given that crowns lose their retention as a result of normal wear, trauma, or other factors over time. There is proper documentation of this procedure for the dentist and the insurance provider.

When Is Recementing a Crown Necessary?

A dental crown may be expected to withstand several years; otherwise, various factors such as normal wear and tear, accidents, and even natural changes in the mouth may cause the crown to get loose or fall off. Another way to fix this is to recement the crown, but how is one supposed to know when that should happen?

The most common causes of dislodged or loose crowns are:

Tooth Decay

Gradually, a tooth may begin to decay, undermining the crown to a point where it is unable to stick firmly to the tooth. If unchecked, decay will also eventually loosen the crown.

Trauma or Injury

Sudden traumatic events, such as a sportsperson colliding with another or falling hard, may dislodge a crown from fairly gentle traumatizing. Sometimes, chewing hard foods is enough to dislodge.

Worn or Weakened Cement

The cement used to hold a crown will obviously wear out over time, especially under the chewing pressure or prolonged stress. The crown can be loosened just like that without trauma or decay.

Signs You May Need a Crown Recemented

Feeling a Loose Crown

Wobbliness or feelings of looseness immediately on gentle tapping by a finger or tongue speak of an urgent need for a visit to the dentist.

Discomfort or Sensitivity 

Discomfort sensitivity may have a story behind it: That is, if the root below the crown hurts when hot or cold temperature is introduced, chances are high that the crown is loose.

The Crown Falls Off

This is probably the most obvious sign! If the crown completely falls off the base, go and see your dentist quickly before you get into any trouble with your tooth. In the case of any of these symptoms, that should be the time you make haste to the dentist.

The Re-cementation Procedure Explained (D2920)

You want to know what it will take to have the crown recemented after it has come loose or fallen off. That should be an easy endeavor, with the intention of returning it to the original situation. Here are the exact steps for it:

The Steps Involved in Recementing a Crown

1. Initial Examination:

The dentist will first examine the tooth very closely along with the crown so that if it is intact or decayed, one ought to be warned. If moderate to severe damage is found on either the crown or the tooth below, it cannot be recemented.

2. Cleaning of the Tooth & Crown:

This step is the most important. The doctor will clean the crown and tooth beneath it, old cement, debris, and bacteria need to be cleaned out so there are no impediments to bonding new adhesive tight.

3. Preparing the Surface:

Then, the dentist rinses the tooth and the crown and conditions the surface of the tooth with gentle etching as needed. The crown will be cleaned, and adjustments will be made if necessary to enhance its fit before final placement.

4. Applying the New Cement:

The new cement, specially designed for use in dentistry, is applied to the tooth, and then, with great care, when placing the crown, your dentist will ensure the fit of the crown is snug and comfortable while aligning the bite with your own natural one.

5. Positioning and Adjustments:

The crown is seated, and your dentist would ask you to bite down gently for an initial check of the crown’s alignment. Adjustments for a better fit and feel would be made at that time.

6. Curing the Cement:

A curing light would be used if there was a need for the cement applied to cure before securing the crown in place; this would absolutely secure the crown for use.

Duration of the Procedure

Generally, a whole process from 30 to 45 minutes usually accounts for a small period with regard to recementation. The duration it takes is far less compared to all the time and cost spent in getting a new crown. Most patients run in and out from the dentist in less than an hour, making it a fairly straightforward procedure to restore a crown with no extensive work involved.

Is It Painful?

Luckily, recementing a crown is usually not painful; it is mainly cleaning and cementing, with no major invasive procedures required to be performed. If your tooth is known to be sensitive but there are no further decaying tissues, your dentist might recommend local anesthesia just to make it comfortable during the procedure.

Most patients report a feeling of pressure during the adjustment process of the crown, but it should not be painful. One could experience mild discomfort or a bit of sensitivity, but that will pass rather quickly as the tooth and the gum will get used to the presence of the new crown. Any discomfort you had with your previous crown would have been relieved with recementing of a crown-a-well-seated crown.

Insurance Coverage for D2920: What You Need to Know

When getting a dental crown recemented, you want to know what your policy includes in that aspect. In general, recementing a crown is normal; the difference in coverage is determined by the company that provides your health insurance and the plan itself. Here’s a guide that will help you with insurance dental billing and things to check when you are getting that crown recemented.

Insurance Billing Considerations for Recementing a Crown

Because dental insurance can often be quite tricky and variable, not all plans cover the process of recementing a crown in the same way: most generally, though, it’s going to be considered a restorative procedure. Most of the dental insurance plans embrace it under D2920, sometimes depending on the coverage extent that varies based on the following factors:

• Your plan’s policy: Some dental plans list recementation under their general, restorative services, whereas others list it as part of repair or maintenance procedures with a set of different coverage rules.
• Frequency of coverage: Your insurance may have a restriction on the timing to recement the crown if you have done it several times in a short period. So check with your provider and develop an understanding of the limits.
• Existing conditions: If the crown needs recementing because it is decayed or there is some damage to the underlying tooth, expect additional considerations or treatments to be involved that may affect your insurance coverage.

How to Check If Your Procedure Is Covered

Calling your insurance provider would give a good idea even before any complication arises. Here is how to ensure your recementation will be fully covered:

1. Contact Your Insurance Provider:

Get in contact either with your dental insurance company or provider and ask about D2920 coverage. They will answer whether recementing a crown is covered under their plan, as well as any limitations or exclusions.

2. Ask About Pre-authorization:

Certain insurance companies usually require pre-authorization before they cover the dental procedure. Crown recementation is one of those.

3. Review Your Plan Details:

Go through your dental insurance plan to know the types of treatments included and those excluded. This will give you a good view of what is covered and what is not.

4. Clarify Deductibles and Copays:

Be aware of any possible deductibles or copays related to the process of recementation. These costs tend to be different depending on the insurance plan, and therefore, they should be known before proceeding.

Common Insurance Policies for D2920 Treatments

Insurance policies differ in their clauses regarding coverage. However, most dental plans consider D2920 as a restorative service. Thus, here is an outline of the general coverage under common dental plans with respect to D2920:

• PPO (Preferred Provider Organization) Plans:

However broad these plans and procedures of dental offerings, crown recementation is usually covered by PPOs. The percentage coverage of such type of procedures is stated in your plan and sometimes have a limitation of days waiting to be eligible for that treatment under a particular PPO plan.

• HMO (Health Maintenance Organization) Plans: 

You may be required to go to a network dentist to recement a crown in an HMO plan. Usually, less coverage, compared to a PPO plan, is involved with this form of treatment, and you may also need to undergo a certain course for approval.

• Indemnity or Fee-for-Service Plans: 

All these plans offer freedom to select the dentist among the plan options, but you may be required to pay upfront and request reimbursement from the insurance company after claiming for D2920.

• Discount or Dental Savings Plans: 

The recementation of a crown could be covered by a discount or dental savings plan, although this might differ with regard to most of the plans.

D2920 vs. Related Dental Codes

When crowns and related things are involved, each tooth requires its procedures around which codes are placed. D2920 is only used for recementing the dental crown; other codes cover something similar but not the same. A table to compare D2920 against other common codes in dentistry is as follows:

Explanation of Differences:

• D2920: This involves the recementation of an existing crown that becomes loose or dislodged without making a significant change to the tooth underneath.
• D2740: It is placing a brand new porcelain or ceramic crown. This type of procedure is generally indicated for dental aesthetic purposes due to the inherent tooth likeness of those materials.
• D2950: For strength, build up a core for a tooth, after which a new crown can be placed. The procedure becomes necessary if destruction and or decay have rendered the tooth unfit to accommodate a crown on its own.
• D2910: It’s much like D2920, except inlays or onlays replace crowns. Here, you have partial restorations reattached as opposed to a complete tooth cover.

How to Prevent Future Crown Issues in D2920

Prevent future problems with crown recementation or failure of the tooth underneath with proper care and attention. Following simple, proactive steps significantly reduces the chance of having to go through a procedure requiring D2920 shortly after it has been done. Here are ways of keeping your crown in good condition and your teeth healthy:

1. Good Oral Hygiene

Good oral hygiene practices prevent any dental problems, including the necessity for a recemented crown. A healthy crown and underlying tooth will not easily lose the crown because of some decay or damage.

• Brush regularly: 

Brushing of teeth is done at least twice daily with fluoridated toothpaste. Be careful to brush around the edges of the crown to prevent the accumulation of debris that can cause cement failure.

• Floss daily: 

Flossing should never be lost in an oral hygiene routine since crowns can trap food particles just like under the crown and may have gunk buildup under the crown. This keeps that area clean and healthy by regular flossing.

• Use mouthwash: 

Rinse using an antimicrobial mouthwash in order to limit the amount of bacteria residing in your mouth, which is beneficial for the health of your gums, preventing infections that might affect the crown. 

Good maintenance of these activities ensures that the crown will last longer and may require less intervention like recementing.

2. Avoid Hard and Sticky Food

Some foods put unnecessary stress on the crown, thus causing it to loosen, crack, or even fall. Be careful because the next point contains these: 

(a) Hard foods: Do not bite anything hard, including ice, nuts, or even hard candies. It can cause accidents where your crown can break or easily dislodge. Even something hard, like carrots, can put undue pressure on your crown. 

(b) Sticky foods: Chewing gum, caramel, and taffy are the foods that stick well in these categories. They may pull the crown, therefore weakening the tooth-to-crown bond. They may also cling to the underside of the crown and lead to decay or discomfort. These would then cause stress to your crown and further damage that can lead to recementing.

3. Attend Regular Dental Checkups 

For the health of the crown and the surrounding teeth, regular dental inspections are absolutely necessary. The dentist will do the following during a checkup:

Crown Inspection: The dentist would check to see that the crown had not loosened or broken and was correctly fitted.

Monitor the tooth beneath: The dentist would examine the underlying tooth for decay, wear, or any other reason that could compromise the functional integrity of the crown.

Professional Cleaning: This has to be done to guarantee the crown is free of tartar and plaque that could hinder one’s oral condition and cause it to become loose.

Regular appointments help one to identify a problem early and prevent it from deteriorating into something needing D2920.

4. Protect Your Teeth From Injury

You might want to think about using a mouth guard for sports that could damage your teeth, including contact sports. The guard helps to shield the crown from shocks that might otherwise loosen or destroy it.

Following these basic guidelines of cleanliness, not eating hard or sticky meals, having regular dental checkups, and tooth defense from damage will significantly lower the likelihood of the D2920 procedure. Proper dental practices help to keep the crown in place and support general dental health.

Conclusion

Accurate documentation and coding follow successful dental treatments. Proper use of the code guarantees that the provider is fairly paid and goes further to create a quick patient encounter. Small coding mistakes in a quick dental setting can lead to delayed payments, turned-down claims, or compliance difficulties. That is where knowledge sets one apart.

DRG helps practices run smoothly not only by means of dental billing but also by means of clear and confident assistance. From advising on the proper use of codes like D2920 to claim submission and appeals, we partner with you in revenue cycle management. DRG can assist you relieve the agony of dental billing and convert accuracy into revenue.