03 Jul Code Tip: D2740
Can you use D2740 and by report to charge for a crown upgrade?
Charging an additional fee for an “upgrade” is a big no no for PPO plans but you can bill for the service if it is a real extra service that can be documented. You can bill the upgrade fees as the miscellaneous code with a narrative. It is usually a non covered service and the patient would pay out of pocket. Be very clear in the narrative what material it is and what is different from the covered service. Include the lab bill as an attachment. The code D2740 was revised this year (2018) to exclude the word “substrate”
DHMO differs as you can charge for lab fees up to $200 without providing this information
2740 is an all ceramic/porcelain crown. If the plan downgraded the crown to a D2791 or D2792, you are able to charge the difference based on the fee schedule not the office fee.
eAssist Helpful News and Billing Tips; Edition #125