Shopping Cart
Your Cart is Empty
There was an error with PayPalClick here to try again
CelebrateThank you for your business!You should be receiving an order confirmation from Paypal shortly.Exit Shopping Cart

National Dental Billing Services

1810 Erie Blvd. Syracuse, NY 13210

[email protected]




What is the most ridiculous, confusing, most denied procedure dentists bill insurance for?

Posted on October 17, 2015 at 11:30 AM

Q: What is the most ridiculous, confusing, most denied procedure dentists bill insurance for?

A: The simple core buildup has been redefined by both the insurance companies and the ADA in the past 2 years. Somehow, over the years, insurance companies have decided that the core build-up is part of a crown procedure and thus have avoided paying us for it. Delta Dental, Metlife, Guardian, Pomco all guilty of selling a plan to employers with the clause of core-crown bundling. How they got away with this bundling I have no idea. The fact is that not only do they not pay for it, but if you are a provider, by contract they don't let you charge the patient for it either! Another frequent denial is that “the x-rays reveal that THERE IS enough tooth structure present to support an indirect restoration without the core”! We have seen this denial with replacement of an existing crown. Now how on earth can the examiner see that there is enough tooth structure from an x-ray that shows existing crown blocking everything. Isn’t this crazy?.

Anyway, in response to this the ADA (in their 2014 dental codes update) came out with a new code D2949 (restorative foundation for an indirect restoration) to redefine clinically what we are doing. Now we need to identify whether we did D2949 (placement of restorative material to yield a more ideal form, including elimination of undercuts) or did D2950 (refers to building up of coronal structure when there is insufficient retention for a separate extra-coronal restorative procedure. A core buildup is not a liner to eliminate any undercut, box form, or concave irregularity in a preparation).

Let me tell you the implications here. First of all, often, the insurance companies do not cover new codes for at least 5 years. So if you are doing D2949 you need to charge the patient sicne there will not be any help from insurance there. By creating 2 codes our patients now have 50% chance of getting help from their insurance. The good old core buildup that was meant to improve the retention, to yield a more ideal form, to rebuild missing tooth structure, or to support the tooth after root canal procedure now is categorized pretty much by how much material you used and where. We all know that many cores are done to yield a more ideal form, including elimination of undercuts. Seriously? Why the difference, why did ADA do this to us? A core is a core…functions as a support to a crown no matter where or how much the dentin is rebuild or filled-in to eliminate undercuts. We get annoyed when submitting cores because often we get funky denials. There are way too many plan specific insurance clauses which in the end DO NOT pay for the core build-up. Especially in provider practices

Categories: clinical dentistry, dental insurance

Post a Comment


Oops, you forgot something.


The words you entered did not match the given text. Please try again.


Reply goyard
7:26 PM on October 8, 2020 
When I initially commented I clicked the -Notify me when new comments are added- checkbox and now every time a remark is added I get 4 emails with the identical comment. Is there any means you may remove me from that service? Thanks!
Reply Charlesgah
1:57 PM on October 10, 2020 
Reply chrome hearts online
5:39 PM on October 10, 2020 
Youre so cool! I dont suppose Ive read anything like this before. So nice to search out somebody with some authentic thoughts on this subject. realy thank you for beginning this up. this website is one thing that is needed on the net, somebody with a little originality. useful job for bringing one thing new to the internet!
chrome hearts online
Reply kobe byrant shoes
8:28 PM on October 10, 2020 
I?m impressed, I need to say. Really hardly ever do I encounter a weblog that?s each educative and entertaining, and let me tell you, you could have hit the nail on the head. Your concept is outstanding; the difficulty is one thing that not sufficient persons are talking intelligently about. I'm very joyful that I stumbled throughout this in my seek for one thing regarding this.
kobe byrant shoes
Reply cheap erectile dysfunction pills online
7:21 AM on October 11, 2020 
best erectile dysfunction medication best erectile dysfunction medication
Reply golden goose outlet
4:30 PM on October 12, 2020 
The next time I learn a weblog, I hope that it doesnt disappoint me as a lot as this one. I imply, I know it was my choice to learn, however I truly thought youd have something fascinating to say. All I hear is a bunch of whining about one thing that you could possibly repair if you werent too busy on the lookout for attention.
golden goose outlet
Reply hermes belts for men
7:16 PM on October 12, 2020 
I�m impressed, I have to say. Really hardly ever do I encounter a weblog that�s both educative and entertaining, and let me inform you, you have got hit the nail on the head. Your concept is outstanding; the problem is something that not enough individuals are talking intelligently about. I am very glad that I stumbled across this in my search for one thing relating to this.
hermes belts for men
Reply adidas yeezy
2:11 PM on October 14, 2020 
you could have an ideal weblog here! would you prefer to make some invite posts on my weblog?
adidas yeezy
Reply jordan 11
5:06 PM on October 14, 2020 
I was very pleased to find this web-site.I needed to thanks in your time for this glorious learn!! I undoubtedly enjoying every little little bit of it and I've you bookmarked to take a look at new stuff you weblog post.
jordan 11
Reply Robertcrelt
10:59 PM on October 14, 2020 
best erectile dysfunction pills cheap erectile dysfunction pills online
Reply cheap jordans
11:21 AM on October 16, 2020 
I am usually to blogging and i really respect your content. The article has really peaks my interest. I am going to bookmark your site and maintain checking for new information.
cheap jordans
Reply kyrie 4
3:56 PM on October 16, 2020 
Can I simply say what a reduction to find somebody who actually is aware of what theyre talking about on the internet. You definitely know the way to carry an issue to mild and make it important. Extra folks need to read this and perceive this aspect of the story. I cant imagine youre not more widespread because you positively have the gift.
kyrie 4
Reply Robertcrelt
6:43 PM on October 18, 2020 
treat erectile dysfunction without drugs erectile pills canada erectile vacuum pump costs
Reply Robertcrelt
10:57 PM on October 18, 2020 
erectile shockwave erectile dysfunction treatment men with erectile dysfunction
Reply steph curry shoes
7:08 PM on October 20, 2020 
I simply had to thank you very much yet again. I am not sure the things I would've made to happen in the absence of the actual recommendations shown by you on this topic. It was the alarming difficulty in my position, however , understanding a well-written fashion you managed that forced me to jump over contentment. I am just happier for the support and thus believe you know what a great job that you're carrying out teaching other individuals thru your web blog. I am sure you've never got to know any of us.
steph curry shoes
Reply balenciaga
2:55 AM on October 21, 2020 
I must show some appreciation to this writer for rescuing me from this type of difficulty. As a result of scouting through the the web and meeting notions which are not helpful, I assumed my entire life was done. Living minus the solutions to the difficulties you have sorted out by way of your main post is a crucial case, and the ones which might have in a negative way affected my career if I hadn't come across your web blog. Your good mastery and kindness in touching all things was tremendous. I'm not sure what I would've done if I hadn't discovered such a step like this. I can at this point look ahead to my future. Thanks a lot very much for this impressive and effective help. I won't think twice to recommend the blog to anybody who should get assistance about this problem.
Reply chrome hearts store
12:58 AM on October 23, 2020 
I truly wanted to make a brief comment to be able to thank you for these amazing ways you are giving on this website. My long internet research has finally been recognized with awesome points to write about with my family. I would admit that most of us website visitors are extremely endowed to live in a really good place with very many lovely people with great tactics. I feel rather lucky to have encountered your entire site and look forward to tons of more cool minutes reading here. Thanks once more for everything.
chrome hearts store
Reply cheapest ed drugs
12:30 AM on October 25, 2020 
best erectile dysfunction medicine erection pills online erectile home remedy

is erectile dysfunction normal
Reply pandora jewelry
9:49 PM on October 25, 2020 
I wish to point out my affection for your kind-heartedness for those people who have the need for help with this important issue. Your personal commitment to getting the message all around had been really valuable and has constantly enabled those just like me to arrive at their endeavors. Your personal insightful useful information can mean a great deal to me and much more to my peers. Thanks a lot; from all of us.
pandora jewelry
Reply esurance
8:41 AM on October 31, 2020 
interactive sex new car insurance