D2980 - Crown Repair
Crown repair necessitated by material failure.
- Procedure Code
- D2980
- 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 D2980.
- Frequency Limitation
- Subject to group/individual contract frequency limitations (none)
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.
- Fees for a crown repair completed on the same date of service as a new crown are not billable to the patient.
- Fees for crown repair are not billable to the patient within 24 months of the original restoration by the same dentist/dental office.
- Benefits for D2980 are denied within 24 months of the original restoration by different dentist/dental office.
- 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. |
ICD-10-CM Justification & Crosswalk Mappings for D2980 (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 D2980.
Frequently Asked Questions — D2980 (Crown Repair)
Quick answers for dental billers and treatment coordinators submitting claims for D2980.
What ICD-10 diagnosis codes link to dental procedure D2980?▾
Currently no specific ICD-10 crosswalk mappings recorded for CDT D2980.
Can CDT code D2980 be billed to medical insurance?▾
Billing CDT D2980 (Crown Repair) 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 D2980?▾
Required claim attachments for CDT D2980 (Crown Repair) include: Standard ADA claim form with CDT procedure code and date of service.
What is the insurance frequency limitation for CDT D2980?▾
Standard commercial insurance frequency for D2980: Subject to group/individual contract frequency limitations (none).
What are common insurance denial reasons and appeal tips for CDT D2980?▾
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.