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# Gold Crown Dental Code D2790: Teeth Restoration and Procedure Guide

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- May 1, 2025

Gold crowns containing at least 60% noble metal content are classified under the American Dental Association (ADA) Code D2790, which refers to full cast high noble metal crowns. This standardized classification brings clarity to insurance procedures and billing practices. This code applies to crowns composed entirely of high noble alloys that offer remarkable durability against corrosion while showing excellent biocompatibility to be used safely for molar teeth. The complete restorations covered by D2790 extend to dental crowns, while codes linked to it address gold foil treatment options, among others, based on cavity size.

Both dentists and insurers can distinguish gold crowns from other options, such as porcelain-fused-to-metal (D2750) or all-ceramic crowns (D2740), through the code’s specific traits because this enhances administrative clarity and emphasizes gold’s clinical advantages in high-stress areas.

## What Makes Gold Crowns Unique?

High-noble metal alloys with a minimum value of 60% precious metals, including gold, platinum, and palladium, create gold crowns that show excellent resistance to corrosion coupled with exceptional biocompatibility. The exact fit of these crowns results in a minimal reduction of tooth structure combined with effective bacterial prevention.

The wear rate of gold matches natural enamel teeth, which prevents damage to the opposing dental structure. Gold crowns provide long-lasting performance despite their metallic appearance and increased initial cost because they remain resilient for more than 15 years. These prosthetic teeth fulfill their function across posterior molars and teeth situated in the back of the mouth by withstanding exceptional chewing forces. Insurance billing processes become easier through the application of the ADA code D2790. As an aesthetic drawback, they have become less popular, but these crowns deliver unmatched strength and extended durability in high stress areas.

## When Dentists Recommend Gold Crowns (ADA Code D2790)?

According to dentists, the recommended treatment used for durability and biocompatibility is gold crowns (which get coded as ADA D2790 for full-cast high noble metal crowns). These crowns use noble metals that exceed 60% of the content of gold, along with platinum and palladium, because they provide several advantages for dental health.

- Posterior teeth, along with molars, need crowns that hold up against heavy chewing forces because they help prevent fractures.
- These crowns will shield teeth with root canal treatments that are liable to split.
- Restoring teeth through gold crowns remains a suitable option when the remaining healthy tooth structure amounts to minimal density.
- Through its malleability quality, gold helps prevent tooth damage from opposing teeth during bruxism events.
- High noble alloy materials decrease the chances of metal sensitization in patients.

High noble alloy crowns that use all the specified materials require the D2790 code to accurately reflect their advanced material expenses and custom manufacturing process. A gold crown requires lower tooth reductions during placement when compared to porcelain restorations because it preserves biological tooth structure while its tight fit blocks the possibility of new decay formation. Long-lasting at 15 to 40 years, these crowns represent the top choice for high-pressure restorations because of their longevity.

## CDT Codes for Gold Crowns

### D2790 – Crown, Full Cast High Noble Metal

1. Definition:

Contains ≥60% noble metals (gold, platinum, palladium), with ≥40% gold specifically.

2. Uses:

Ideal for molars, root canal-treated teeth, and bruxism cases due to unmatched durability and biocompatibility.

3. Durability:

Lasts 15–40 years with minimal wear on opposing teeth.

### D2791 – Crown, Full Cast Predominantly Base Metal

1. Definition:

Contains <25% noble metals (majority base metals like nickel/chromium).

2. Uses:

Lower-cost option for non-aesthetic areas where budget outweighs longevity concerns.

3. Drawbacks:

Higher risk of tarnishing and nickel allergies.

### D2792 – Crown, Full Cast Noble Metal

1. Definition:

Contains 25–59% noble metals (less gold than D2790).

2. Uses:

Balances cost and performance for premolars or moderate-stress teeth.

3. Advantages:

Better biocompatibility than D2791, more affordable than D2790.

## How Dentists Decide Which Code to Use

Dental practitioners use CDT codes, specifically D2790, after verifying metal levels through laboratory material reports and their clinical evaluation needs. Correct documentation guarantees insurance compliance, as well as supports patient transparency, together with legal accuracy that prevents claim rejections plus wrong billing. The labs establish alloy specifications (metal ratios) that directly determine which treatment codes may be used.

A doctor’s choice of dental procedures depends on both clinical considerations about the bite force and allergy risks. The correct implementation of coding helps prevent disagreements between providers and guarantees patients get the material quality they require for their treatment. Insurance audits perform their verification process based on the CDT coding system to validate payment reimbursement amounts.

## How to Verify the Code Used for Your Treatment

Request your dentist to explain the CDT code (such as D2790) from your treatment plan or claim form while obtaining material reports from dental laboratories to confirm alloy compositions, which are essential for the D2790 code. Cross-check the treatment details with the provider information, such as a full cast high noble metal crown for D2790, and review the convenience benefit statement with the insurance EOB to verify that the selected code covers your services. Discrepancies should be addressed by obtaining written documentation of all codes and services, which helps resolve billing and coverage problems.

## Step-by-Step Procedure for D2790 – Full Cast High Noble Metal Crown

The D2790 procedure describes a gold crown or full-cast high noble metal crown that requires metal alloys containing at least sixty percent noble metals, such as gold. This restoration follows such steps for execution:

### 1. Initial Consultation and Examination

Purpose: The oral health assessment determines whether a crown is needed, along with selecting high noble metal as the appropriate material.

Diagnostic Imaging: The dental professional takes diagnostic imaging through X-rays to examine both the tooth structure and the surrounding bone tissues.

Treatment Planning: The dentist must perform a treatment planning session where patients can decide between appearance aspects, material strength, and expense. The dental professional will describe how high noble metal crowns combine force-reliable construction with enduring performance during this step of discussion.

### 2. Tooth Preparation

Local Anesthesia: The affected tooth area requires a local anesthetic application to numb all surrounding tissue.

Tooth Reduction: The dentist performs tooth reduction through shaping and reduction of affected tooth material and removal of decayed portions. This involves:

- The dentist needs to reduce the tooth so the crown can fit correctly with its thickness dimensions.

- The dental professional shapes the tooth so that it can receive a secure crown placement.

The reduction of tooth structure by dental crowns depends on design requirements and normally requires removing 1-2 millimeters from the tooth surface.

### 3. Impressions

Impression Material: After completing the proper preparation of the tooth, the dentist produces a mold of the ready tooth using impression material. This can be done using:

- One of the available options for taking impressions includes using traditional impression material. Either alginate or polyvinyl siloxane performs this process effectively.
- Patients can opt for digital scanning because it delivers more precise and comfortable outcomes. The dental laboratory requires the exact dimensions and shape of the prepared tooth that was captured during the impression process.

Bite Registration: Dental professionals use bite registration tests to evaluate how the crown will integrate with the bite and occlusal structure, thus preventing alignment problems.

### 4. Temporary Crown

Temporary Crown Placement: Permanent crown production requires the dentist to insert a temporary crown onto the prepared tooth, which protects the target area until the final product arrives from the dental laboratory.

- The employed temporary crown uses plastic or acrylic as its composition.
- The dentist checks that the fit and comfort functions of the temporary crown are optimal.

### 5. Fabrication of the Gold Crown

The dental laboratory receives impressions of bite registration through which skilled technicians perform the following tasks:

- A dental technician creates the full-cast gold crown by making a mold and transforming it into a shape from platinum, palladium, and gold high noble metal alloys.
- The technician designs a perfect-fitting crown by giving it a proper biting surface and matching contours.

The crown contains increased durability and biocompatible features from its high noble metal structure, which primarily consists of gold.

### 6. Try-In Appointment

Fitting the Permanent Crown: The patient visits the dentist for the try-in appointment after the permanent crown’s fabrication.

- At this stage, the dentist checks the correct placement of the prepared tooth crown while evaluating the occlusal relationship of the biting surfaces.
- The dental professional conducts additional modifications to the crown based on fit level and bite positioning as well as shape needs.
- The dentist performs a color examination because gold crowns typically have functional purposes only, although they normally do not improve dental aesthetics.

### 7. Bonding and Cementing the Crown

Cleaning the Tooth: The dentist needs to completely clean both the marked tooth surfaces together with any remaining temporary cement and debris from the past crown.

Cementation: Special bonding agents or dental cement are applied onto the inside surface of the gold crown by a dentist.

- Placing the crown is completed when a dentist positions it strongly over a prepped tooth.
- Special light resin will be used by the dentist to cure light-cured resins after application.

Final Adjustments: The dentist conducts ultimate modification steps to maintain perfect crown positioning while maintaining proper jaw coordination and a comfortable wearer experience.

## Tips for Communicating with Your Dentist About Crowns

1. Know Your Preferences: Before making a decision about your crown, you should establish which characteristic you value more: lasting quality or attractive appearance. Selected patients must choose between gold crowns for their dental longevity or porcelain crowns for their natural appearance.
2. Consider Location: The area of your teeth determines which crowning material to choose, since gold works best on molars, yet porcelain suits incisors for looks.
3. Discuss Lifestyle Factors: Renounce your dental practice of grinding or allergic reactions to your dentist to allow for proper material decision-making.
4. Ask About Longevity: Enquire about the lifespan duration of each material while learning about the needed special care procedures.

## CDT Code D2790 vs. Other Metal Crown Codes

CDT Code | Description | Metal Type | Noble Metal Content
D2790 | Crown – full cast high noble metal | High noble metal | ≥ 60% noble metal (≥ 40% gold)
D2791 | Crown – full cast predominantly base metal | Base metal | < 25% noble metal
D2792 | Crown – full cast noble metal | Noble metal | ≥ 25% and < 60% noble metal
D2910 | Re-cement or re-bond inlay, onlay, veneer, or partial coverage restoration | – | –
D2920 | Re-cement or re-bond crown | – | –
D2930 | Prefabricated stainless steel crown – primary tooth | Stainless steel (base metal) | 0% noble metal
D2931 | Prefabricated stainless steel crown – permanent tooth | Stainless steel (base metal) | 0% noble metal
D2980 | Crown repair necessitated by restorative material failure | Varies | Varies
D2999 | Unspecified restorative procedure, by report | Varies | Varies

Medical laboratories should verify that the crowns they provide meet high noble metal requirements to enable the proper processing of D2790 insurance claims.

## Billing and Insurance Considerations for Code D2790 – Gold Crown

The full-cast crown described by CDT code D2790 consists of high noble metal components, which are usually made from gold. The widely accepted CDT code D2790 coincides with dental insurance plan coverage, yet requires an appreciation of particular payment and insurance rules.

### 1. What D2790 Includes

- Tooth preparation
- Impression or digital scan
- Fabrication of a high noble metal crown (≥60% noble metal, with ≥40% gold)
- Placement and cementation of the crown

The service does not include core build-up under D2950 or root canal therapy under D3310-D3330, which must be billed separately according to treatment requirements.

### 2. Insurance Coverage

Often Covered, But Not Fully:

Planned coverage from dental insurance extends to crowns, although payments are split between 40-80% according to policy specifications and crown materials.

Frequency Limitations:

Within dental insurance plans, a single tooth is restricted from receiving coverage only once within periods of 5 to 10 years. Any replacements occurring ahead of the five-year limit will usually require being medically necessary for coverage to apply.

### 3. Material Downgrade Clauses

- Insurance policies exist that reimburse patients solely for receiving base metal crowns (D2792).
- Insurance companies provide coverage for a base metal crown equivalent value, although you select a gold crown.
- The remaining expenses will require the patient to pay directly.

### 4. Preauthorization and Documentation

Preauthorization Recommended:

Numerous insurance firms need healthcare providers to get pre-treatment cost estimates along with preauthorization for installing gold crowns.

Supporting Documentation:

- Clinical notes
- X-rays
- Periodontal status (if applicable)
- Material disclosure provided by the laboratory

### 5. Out-of-Pocket Considerations

- Other materials generally lead to lower co-pay amounts for patients because gold crowns typically result in more expensive laboratory processing.
- The patient needs to understand this information in advance and receive an estimate of the treatment costs before starting the procedure.

### 6. Tips for Billing Offices

- Use clear CDT coding and present documentation at the beginning of the billing process.
- Submit laboratory invoices together with composition reports upon request.
- The practice team should help patients understand the downgrading process and show them how their benefits will change between crown choices.

## Points of Interest for Patients Regarding Gold Crowns

### 1. What is Dental Gold?

Dental gold represents a highly noble metal alloy that uses at least 40% gold alongside 60% noble metals, with platinum or palladium among them for crown applications. The dental field trusts gold due to its lasting nature, tight placement abilities, and nonallergic qualities.

### 2. How Much Gold Is in a D2790 Gold Tooth?

All D2790 crowns must have at least 40% of their mass weighted as gold. Most dental crowns weigh between 1.5 and 2.5 grams, yet contain 0.6 to 1 gram of gold according to the dental alloy composition and tooth dimensions.

### 3. Is a Gold Crown Better Than Porcelain?

Gold crowns deliver superior strength because their primary material consists of gold, making them suited to protect back teeth.

A higher number of people choose porcelain crowns because of their natural appearance on front teeth. A person should select between functional and aesthetic considerations when making their decision.

### 4. How Do I Get a D2790 Gold Crown?

Go to your dentist to get a D2790 gold crown, and they will prepare the tooth and then send the impression data to the lab until the crown is ready for you to receive. The cost of the procedure might be partially covered by your insurance provider, according to plan benefits.

## Conclusion

Dental gold crowns that are billed under CDT code D2790 offer remarkable strength and the longest possible durability. The dental gold crown selection works best for teeth in the molar regions and areas that need high chew resistance.

The clinical performance of gold crowns surpasses porcelain crowns, even though they provide a lower degree of aesthetic quality. Unlike other CDT codes, understanding D2790 helps optimize insurance billing practices and treatment planning procedures. When teeth grinding is present, or a crown is needed to withstand long-term use, gold becomes the preferred solution.

Dental Resource Group (ADR) staff provides reliable assistance in dental billing. For expert billing services, whether related to dental gold crowns, other codes, or maximizing reimbursement, contact DRG today.

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