D2392 - Resin (2 Surf Post)
Resin composite - 2 surfaces, posterior.
- Procedure Code
- D2392
- Clinical Category
- Restorative
- Primary ICD-10 Justification
- K02.52 (Dental caries on pit and fissure surface penetrating into dentin)
- Reference Fee & Claim Types
- BOTH
Insurance Verification Benchmarks & Billing Guidelines
Payer policy benchmarks, pre-submission attachment requirements, and denial prevention rules for D2392.
- Frequency Limitation
- 1 per surface in a 24-month interval (rolling_12_months)
- Downgrade Policy Warning
- Posterior composite restoration is subject to PPO alternate benefit; payable as amalgam allowance (D2150).Alternate Code: D2150
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 Code | Denial Reason | Appeal & Overturn Strategy |
|---|---|---|
| CO-119 | Benefit maximum or frequency limitation exceeded for procedure | Submit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria. |
| CO-96 | Non-covered charge / Downgraded under Least Expensive Professionally Accepted Treatment (LEPAT) | Submit clinical photographs and narrative documenting why the alternate benefit material is clinically contraindicated. |
ICD-10-CM Justification & Crosswalk Mappings for D2392 (11)
Click any ICD-10-CM diagnosis code below to inspect its reverse procedure mappings and differential coding guide.
| ICD-10 Code | Diagnosis Name | Category | Primary Justification | Claim Type | Clinical Scenario |
|---|---|---|---|---|---|
| K02.52 | Dental caries on pit and fissure surface penetrating into dentin | Dental caries | ★ Yes (Primary) | BOTH | resin-based composite – two surfaces, posterior indicated for Dental caries on pit and fissure surface penetrating into dentin |
| K02.51 | Dental caries on pit and fissure surface limited to enamel | Dental caries | Secondary | BOTH | resin-based composite – two surfaces, posterior indicated for Dental caries on pit and fissure surface limited to enamel |
| K02.53 | Dental caries on pit and fissure surface penetrating into pulp | Dental caries | Secondary | BOTH | resin-based composite – two surfaces, posterior indicated for Dental caries on pit and fissure surface penetrating into pulp |
| K02.61 | Dental caries on smooth surface limited to enamel | Dental caries | Secondary | BOTH | resin-based composite – two surfaces, posterior indicated for Dental caries on smooth surface limited to enamel |
| K02.62 | Dental caries on smooth surface penetrating into dentin | Dental caries | Secondary | BOTH | resin-based composite – two surfaces, posterior indicated for Dental caries on smooth surface penetrating into dentin |
| K02.63 | Dental caries on smooth surface penetrating into pulp | Dental caries | Secondary | BOTH | resin-based composite – two surfaces, posterior indicated for Dental caries on smooth surface penetrating into pulp |
| K02.7 | Dental root caries | Dental caries | Secondary | BOTH | resin-based composite – two surfaces, posterior indicated for Dental root caries |
| K03.1 | Abrasion of teeth | Other diseases of hard tissues of teeth | Secondary | BOTH | resin-based composite – two surfaces, posterior indicated for Abrasion of teeth |
| K03.2 | Erosion of teeth | Other diseases of hard tissues of teeth | Secondary | BOTH | resin-based composite – two surfaces, posterior indicated for Erosion of teeth |
| K03.81 | Cracked tooth | Other diseases of hard tissues of teeth | Secondary | BOTH | resin-based composite – two surfaces, posterior indicated for Cracked tooth |
| S02.5XXA | Fracture of tooth (traumatic), initial encounter for closed fracture | Fracture of skull and facial bones | Secondary | BOTH | resin-based composite – two surfaces, posterior indicated for Fracture of tooth (traumatic), initial encounter for closed fracture |
Frequently Asked Questions — D2392 (Resin (2 Surf Post))
Quick answers for dental billers and treatment coordinators submitting claims for D2392.
What ICD-10 diagnosis codes link to dental procedure D2392?▾
Common ICD-10-CM justification codes for CDT D2392 (Resin (2 Surf Post)) include: K02.52 - Dental caries on pit and fissure surface penetrating into dentin (Primary); K02.51 - Dental caries on pit and fissure surface limited to enamel; K02.53 - Dental caries on pit and fissure surface penetrating into pulp; K02.61 - Dental caries on smooth surface limited to enamel; K02.62 - Dental caries on smooth surface penetrating into dentin; K02.63 - Dental caries on smooth surface penetrating into pulp; K02.7 - Dental root caries; K03.1 - Abrasion of teeth; K03.2 - Erosion of teeth; K03.81 - Cracked tooth; S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture.
Can CDT code D2392 be billed to medical insurance?▾
Billing CDT D2392 (Resin (2 Surf Post)) to medical insurance depends on the underlying clinical necessity and trauma/pathology documentation. Supported claim types across linked diagnoses: BOTH.
What attachments and documentation are required for billing CDT D2392?▾
Required claim attachments for CDT D2392 (Resin (2 Surf Post)) include: Diagnostic pre-operative radiograph showing affected tooth/area.
What is the insurance frequency limitation for CDT D2392?▾
Standard commercial insurance frequency for D2392: 1 per surface in a 24-month interval (rolling_12_months).
Does dental insurance downgrade CDT code D2392?▾
Posterior composite restoration is subject to PPO alternate benefit; payable as amalgam allowance (D2150).
What are common insurance denial reasons and appeal tips for CDT D2392?▾
Denial Code CO-119 (Benefit maximum or frequency limitation exceeded for procedure): Overturn appeal strategy - Submit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria. | Denial Code CO-96 (Non-covered charge / Downgraded under Least Expensive Professionally Accepted Treatment (LEPAT)): Overturn appeal strategy - Submit clinical photographs and narrative documenting why the alternate benefit material is clinically contraindicated.