D2391 - Resin (1 Surf Post)

Resin composite - 1 surface, posterior.

Procedure Code
D2391
Category
Restorative

Insurance Verification Benchmarks & Billing Guidelines

Benchmark Policy Source: Delta Dental National / PPO Standard

Frequency Limitation
Once per tooth surface every 24 consecutive months (ROLLING_MONTHS)
Age Limitation
All ages covered.
Downgrade Policy Warning
Many PPO plans downgrade posterior composite restorations to amalgam allowance (D2140). Patient pays the difference.

Required Claim Attachments & Pre-Submission Checklist

  • Specific tooth number and surface (e.g. #19-O) indicated on claim
  • Pre-operative radiograph demonstrating caries penetration into dentin

Bill When (Allowable Clinical Criteria)

  • Treatment of initial caries or replacement of failed restoration on posterior tooth surface (O, B, L)

Restrictions & Clinical Exclusions

  • Do NOT bill replacement of same surface within 24 months by same dentist

Common Claim Denial Codes & Overturn Strategies

Denial CodeDenial ReasonAppeal & Overturn Strategy
CO-119Restoration billed within 24-month replacement periodSubmit narrative detailing recurrent caries or fracture of remaining tooth structure.

ICD-10 Justification & Crosswalk Mappings

ICD-10 CodeDiagnosis NameCategoryPrimary JustificationClaim TypeClinical Scenario
K02.52Dental caries on pit and fissure surface penetrating into dentinDental cariesYes (Primary)BOTHresin-based composite – one surface, posterior indicated for Dental caries on pit and fissure surface penetrating into dentin
K02.51Dental caries on pit and fissure surface limited to enamelDental cariesSecondaryBOTHresin-based composite – one surface, posterior indicated for Dental caries on pit and fissure surface limited to enamel
K02.53Dental caries on pit and fissure surface penetrating into pulpDental cariesSecondaryBOTHresin-based composite – one surface, posterior indicated for Dental caries on pit and fissure surface penetrating into pulp
K02.61Dental caries on smooth surface limited to enamelDental cariesSecondaryBOTHresin-based composite – one surface, posterior indicated for Dental caries on smooth surface limited to enamel
K02.62Dental caries on smooth surface penetrating into dentinDental cariesSecondaryBOTHresin-based composite – one surface, posterior indicated for Dental caries on smooth surface penetrating into dentin
K02.63Dental caries on smooth surface penetrating into pulpDental cariesSecondaryBOTHresin-based composite – one surface, posterior indicated for Dental caries on smooth surface penetrating into pulp
K02.7Dental root cariesDental cariesSecondaryBOTHresin-based composite – one surface, posterior indicated for Dental root caries
K03.1Abrasion of teethOther diseases of hard tissues of teethSecondaryBOTHresin-based composite – one surface, posterior indicated for Abrasion of teeth
K03.2Erosion of teethOther diseases of hard tissues of teethSecondaryBOTHresin-based composite – one surface, posterior indicated for Erosion of teeth
K03.81Cracked toothOther diseases of hard tissues of teethSecondaryBOTHresin-based composite – one surface, posterior indicated for Cracked tooth
S02.5XXAFracture of tooth (traumatic), initial encounter for closed fractureFracture of skull and facial bonesSecondaryBOTHresin-based composite – one surface, posterior indicated for Fracture of tooth (traumatic), initial encounter for closed fracture