D2740 Dental Code: All-Ceramic Crown Billing

The short version

# D2740 Dental Code: All-Ceramic Crown Billing

D2740 is the CDT code for a full-coverage crown made from porcelain or ceramic and placed on one natural tooth. It has no metal substructure and isn't an implant crown or bridge retainer. A payer can accept the crown but calculate the benefit from a lower-cost metal option, adding hundreds of dollars to the patient's share. This guide covers code choice, D2950, replacement rules, service dates, and the EOB math.

• Bill D2740 for a completed porcelain or ceramic crown on a natural tooth. Use the lab material and crown role to rule out D2750, D2751, and D6740.
• The periapical image, note, and photos need to show why a direct restoration won't work and that the tooth's periodontal and endodontic outlook supports a crown.
• A 2026 Cigna Arizona plan applies a base-metal alternate benefit to D2740: D2751 for anterior teeth and bicuspids, and full-cast D2791 for molars. Report D2740 when ceramic was delivered even when the benefit is calculated from another code.
• Replacement clocks differ. The Cigna plan uses 60 consecutive months per tooth, while Minnesota's Program HH uses seven years per tooth and requires authorization.
• Service dates aren't uniform. ADA policy favors the preparation date for fixed prosthodontics, while Delta Dental of Arizona pays crown and bridge benefits on the seat date. Record both and follow the plan.
• In a worked molar downgrade, a $1,450 D2740 charge has a $1,100 contracted allowable. The plan pays $400 from a base-metal alternate benefit, the patient owes $700, and the office adjusts $350.

What is D2740?

D2740 reports a single-tooth crown made from porcelain or ceramic rather than porcelain fused to metal. Report the restoration placed, not the payer's alternate benefit. The ADA Code Maintenance Committee says preparation is one step and crown codes describe placement of the final prosthesis.

When do you bill D2740?

Bill D2740 when the tooth needs full ceramic coverage and the final crown is delivered. Delta Dental's clinical criteria frame the review:

• Does decay, fracture, or a large existing restoration leave enough structural loss to support full coverage rather than a filling?
• Does the tooth have a favorable periodontal outlook and no unresolved endodontic problem?
• Does a current pre-operative periapical image show the tooth's endodontic and periodontal state?
• Does the lab record confirm an all-ceramic or porcelain crown rather than porcelain fused to a metal coping?
• If the reason is a cracked tooth, do the note and tests identify the fracture and the symptoms instead of relying on thermal sensitivity alone?

Don't use D2740 just because the crown is tooth-colored. A porcelain layer over metal points to a D2750-series code. A ceramic crown that holds one end of a fixed bridge points to D6740.

D2740 vs D2750, D2751, D6740, and D2950

The lab material decides D2740 vs D2750 or D2751. The treatment plan decides D2740 vs D6740. D2950 is a separate foundation when the remaining tooth can't retain the crown.

The ADA's D2950 guidance reserves the buildup for missing anatomy needed for crown strength and retention, not routine preparation irregularities. Crown and buildup are distinct procedures, though a plan may bundle their benefits.

What does insurance actually do with D2740?

Check the tooth's prior crown date and material benefit. One 2026 Cigna Arizona plan limits D2740 to once per tooth in 60 months. It calculates anterior and bicuspid benefits from D2751 and molar benefits from D2791, both base-metal alternatives. A Delta Dental Texas plan says its patient owes the difference from the higher-cost option.

Minnesota Program HH uses a seven-year interval per tooth for D2740 and requires authorization. Five years and seven years are both real published rules, so don't estimate from the crown's age alone.

Here is a hypothetical molar claim that shows the downgrade math. The alternate allowable and 50% benefit are example amounts.

• The office bills $1,450 for the D2740 crown.
• The contracted D2740 allowable is $1,100, so the office writes off $350.
• The plan substitutes an $800 D2791 base-metal allowable and pays 50% of that amount, or $400.
• The patient owes $400 as the other half of the alternate allowable, plus the $300 difference between the $1,100 ceramic allowable and the $800 alternate allowable.
• The final patient balance is $400 plus $300, or $700.

The plan didn't change what was placed. The claim remains D2740, while the EOB shows how the benefit was calculated. The adjustment-posting guide helps separate the $350 contract adjustment from the $700 patient balance.

The Washington, DC Medicaid fee schedule listed D2740 at $600 for all ages on May 17, 2025. It isn't a national crown fee. FAIR Health Consumer provides local context, and the current PPO contract supplies the actual allowable.

Service date also needs a payer check. The ADA's policy favors the preparation date for fixed prosthodontic payment. Delta Dental of Arizona pays crowns on delivery or cementation. Record both dates and submit the one the plan requires.

Why does D2740 get denied?

D2740 denials and reduced benefits usually have one of these causes:

• A prior crown or related prosthesis on the tooth falls inside the plan's five- or seven-year replacement interval.
• The payer sees a filling as adequate because the image and note don't prove extensive structural loss or fracture.
• A pre-operative periapical image, requested photo, tooth-specific narrative, or authorization is missing.
• The lab slip supports a porcelain-fused-to-metal crown, or the treatment plan shows a fixed-bridge retainer, so D2740 doesn't match the restoration.
• The tooth has unresolved endodontic disease or an unfavorable periodontal outlook under the payer's clinical criteria.
• D2950 is denied as part of the crown because its separate need isn't shown, even when D2740 itself pays.

What documentation gets D2740 paid?

Send the smallest file that proves the tooth, the material, and the reason for full coverage:

1. Record the tooth number, diagnosis, existing restoration, decay, fracture, and why a direct restoration won't restore the tooth predictably.
2. Include a current pre-operative periapical image. Delta's published criteria request one taken within a year of crown preparation and say not to replace it with a panoramic image.
3. Add available intraoral photographs and a tooth-specific narrative when the structural loss isn't obvious on the radiograph.
4. Record the periodontal and endodontic status, including completed treatment or the plan for any unresolved finding.
5. Keep the lab slip showing the porcelain or ceramic material and whether the crown is a single unit or a bridge retainer.
6. Record both the preparation and final seat dates, plus the prior crown date and why replacement is necessary.
7. If D2950 was performed, document the missing tooth structure and how the buildup created retention for the crown.

If the payer applies the wrong history, material tier, or clinical rule, appeal with the EOB, plan language, images, lab slip, and tooth-specific note. The claim-denial appeal guide gives the letter sequence.

Common questions about D2740

Can a payer downgrade D2740 to a metal crown benefit?

Yes, when the patient's plan contains an alternate-benefit clause. One 2026 Cigna Arizona plan calculates D2740 from D2751 for anterior teeth and bicuspids and from D2791 for molars. Keep D2740 on the claim when that is the crown delivered; the alternate code explains payment, not treatment.

What is the difference between D2740 and D6740?

D2740 is a ceramic or porcelain crown restoring one natural tooth. D6740 is a ceramic or porcelain retainer crown that supports a fixed bridge. Check the treatment plan and lab slip for the crown's role before selecting the code. The pontic and each retainer in a bridge need their own applicable code.

How often will insurance replace a D2740 crown?

Published rules span at least five to seven years. The cited Cigna plan uses 60 consecutive months per tooth, while Minnesota Program HH uses seven years per tooth. A failed crown inside the interval may still be excluded unless the plan has an exception and the record proves it.

Should D2740 use the prep date or seat date?

There isn't one payer rule. ADA policy asks payers to recognize the preparation date for fixed prosthodontics, but Delta Dental of Arizona's transition policy pays crowns on the delivery or cementation date. Verify the plan and record both dates, especially when coverage changes between visits.

Can D2950 be billed with D2740?

Yes, when the dentist separately rebuilds missing tooth structure needed to retain the crown. Don't add D2950 for routine block-out or preparation shape. The ADA recognizes the procedures as distinct, but the plan may bundle the buildup benefit, so send the condition and rationale with the first claim.

Check the next crown estimate

Before the next D2740 prep, verify the prior crown date, alternate-benefit code, service-date rule, and D2950 requirements in the actual plan. Put the downgrade math in the estimate before the patient is numb. Autumn keeps the benefit rule, claim evidence, and EOB follow-up in one dental billing workflow.

Sources

• Delta Dental, clinical criteria for crowns and buildups
• Cigna, 2026 Arizona plan crown limitations and alternate benefits
• Delta Dental, Texas plan alternate-benefit terms
• Minnesota Health Care Programs, Program HH dental services
• ADA, 2022 Code Maintenance Committee action summary
• ADA, patient financing options and prosthodontic payment-date policy
• Delta Dental of Arizona, transition-of-care service dates
• ADA, D2950 core buildup guidance
• Washington, DC Medicaid fee schedule, May 17, 2025
• FAIR Health Consumer, dental cost lookup

CDT codes and nomenclature are copyright © American Dental Association. This guide explains the code in plain language; the current CDT manual is the authoritative source.