D2390 - Resin Crown (Ant)

Resin-based composite crown, anterior.

Procedure Code
D2390
Category
Restorative

Insurance Verification Benchmarks & Billing Guidelines

Benchmark Policy Source: Delta Dental 2026

Frequency Limitation
1 per surface in a 24-month interval (rolling_12_months)

Required Claim Attachments & Pre-Submission Checklist

  • Diagnostic pre-operative radiograph showing affected tooth/area

Bill When (Allowable Clinical Criteria)

  • Indicated for active dental caries or fractured tooth structure extending through enamel into dentin.

Restrictions & Clinical Exclusions

  • Fees for the replacement of amalgam or composite restorations within 24 months are not billable to the patient if done by the same dentist/dental office. Benefits may be allowed if done by a different dentist/dental office. Special consideration may be given by report.
  • In a pit and fissure area, if the resin is limited to the enamel it is considered a sealant or preventive resin restoration. If the resin extends into the dentin, the appropriate composite resin codes should be reported.
  • Infection control is included in the fee for the dental services provided. Separate fees are not billable to the patient.
  • Benefits for restorations for altering occlusion, adjusting vertical dimension, replacing tooth structure lost by attrition, erosion, abrasion, abfraction, corrosion, TMD or for periodontal, orthodontic or other splinting are denied, unless covered by group/individual contract.
  • Benefits for biomimetic restorations (e.g. Biodentine) are denied as investigational.
  • For benefit purposes, local anesthesia is an integral part of the procedure being performed and additional fees are not billable to the patient.

Common Claim Denial Codes & Overturn Strategies

Denial CodeDenial ReasonAppeal & Overturn Strategy
CO-119Benefit maximum or frequency limitation exceeded for procedureSubmit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria.

ICD-10 Justification & Crosswalk Mappings

ICD-10 CodeDiagnosis NameCategoryPrimary JustificationClaim TypeClinical Scenario