D2934 - Crown (Esthetic SS)
Prefabricated esthetic coated SS crown.
- Procedure Code
- D2934
- Clinical Category
- Restorative
- Primary ICD-10 Justification
- See mapped diagnoses below
- Reference Fee & Claim Types
- DENTAL
Insurance Verification Benchmarks & Billing Guidelines
Payer policy benchmarks, pre-submission attachment requirements, and denial prevention rules for D2934.
- Frequency Limitation
- Subject to group/individual contract frequency limitations (none)
- Downgrade Policy Warning
- Benefit only on anterior primary teeth. If submitted for posterior or permanent tooth, alternate benefit allowance for D2930/D2931 applies.Alternate Code: D2930
Required Claim Attachments & Pre-Submission Checklist
- Standard ADA claim form with CDT procedure code and date of service
Bill When (Allowable Clinical Criteria)
- Indicated for medically and clinically necessary treatment as documented in patient's dental record.
Restrictions & Clinical Exclusions
- The fees for buildups are not billable to the patient when buildups are performed in conjunction with inlays, ¾ crowns or onlays.
- Fees for repairs are not billable to the patient within 24 months of the original restoration by the same dentist/dental office. Benefits are denied if done by a different dentist/dental office.
- A prefabricated esthetic coated stainless steel crown is a benefit only on anterior primary teeth. If submitted for a posterior primary tooth or for a permanent tooth, an alternate benefit allowance for prefabricated stainless steel crown - primary tooth (D2930) or prefabricated stainless steel crown - permanent tooth (D2931) is made. The difference between the allowance for the D2930 or D2931 and the approved amount for the D2934 is denied and chargeable to the patient.
- A fee for replacement of a stainless steel crown on a primary or permanent tooth by the same dentist/dental office within 24 months is included in the initial crown placement and is not billable to the patient.
- Benefits for replacement within 24 months of initial placement by a different dentist/dental office are denied and the approved amount is collectable from 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.
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 D2934 (0)
Click any ICD-10-CM diagnosis code below to inspect its reverse procedure mappings and differential coding guide.
No direct ICD-10 mappings recorded for D2934.
Frequently Asked Questions — D2934 (Crown (Esthetic SS))
Quick answers for dental billers and treatment coordinators submitting claims for D2934.
What ICD-10 diagnosis codes link to dental procedure D2934?▾
Currently no specific ICD-10 crosswalk mappings recorded for CDT D2934.
Can CDT code D2934 be billed to medical insurance?▾
Billing CDT D2934 (Crown (Esthetic SS)) to medical insurance depends on the underlying clinical necessity and trauma/pathology documentation. Supported claim types across linked diagnoses: DENTAL.
What attachments and documentation are required for billing CDT D2934?▾
Required claim attachments for CDT D2934 (Crown (Esthetic SS)) include: Standard ADA claim form with CDT procedure code and date of service.
What is the insurance frequency limitation for CDT D2934?▾
Standard commercial insurance frequency for D2934: Subject to group/individual contract frequency limitations (none).
Does dental insurance downgrade CDT code D2934?▾
Benefit only on anterior primary teeth. If submitted for posterior or permanent tooth, alternate benefit allowance for D2930/D2931 applies.
What are common insurance denial reasons and appeal tips for CDT D2934?▾
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.