ADA Insurance Codes for Laboratory Procedures
Fixed
Crowns
D2510 - Inlay - metallic - one surface D2520 - Inlay - metallic - two surfaces D2530 - Inlay - metallic - three or more surfaces D2542 - Onlay - metallic - two surfaces D2543 - Onlay - metallic - three surfaces D2544 - Onlay - metallic - four or more surfaces D2610 - Inlay - porcelain/ceramic - one surface D2620 - Inlay - porcelain/ceramic - two surfaces D2630 - Inlay - porcelain/ceramic - three or more surfaces D2642 - Onlay - porcelain/ceramic - two surfaces D2643 - Onlay - porcelain/ceramic - three surfaces D2644 - Onlay - porcelain/ceramic - four or more surfaces D2650 - Inlay - resin-based composite - one surface D2651 - Inlay - resin-based composite - two surfaces D2652 - Inlay - resin-based composite - three or more surfaces D2662 - Onlay - resin-based composite - two surfaces D2663 - Onlay - resin-based composite - three surfaces D2664 - Onlay - resin-based composite - four or more surfaces D2710 - Crown - resin (indirect) D2720 - Crown - resin with high noble metal D2721 - Crown - resin with predominantly base metal D2722 - Crown - resin with noble metal D2740 - Crown - porcelain/ceramic substrate D2750 - Crown - porcelain fused to high noble metal D2751 - Crown - porcelain fused to predominantly base metal D2752 - Crown - porcelain fused to noble metal D2780 - Crown - 3/4 cast high noble metal D2781 - Crown - 3/4 cast predominantly base metal D2782 - Crown - 3/4 cast noble metal D2783 - Crown - 3/4 porcelain/ceramic D2790 - Crown - full cast high noble metal D2791 - Crown - full cast predominantly base metal D2792 - Crown - full cast noble metal D2799 - Provisional crown D2952 - Cast post and core in addition to crown D2953 - Additional cast post - same tooth (use with D2952) D2961 - Labial veneer - resin laminate D2962 - Labial veneer - porcelain laminate D2980 - Crown repair, by report - includes crown removal D2999 - Unspecified restorative procedure, by report Bridges D6210 - Pontic - cast high noble metal D6211 - Pontic - cast predominantly base metal D6212 - Pontic - cast noble metal D6240 - Pontic - porcelain fused to high noble metal D6241 - Pontic - porcelain fused to predominantly base metal D6242 - Pontic - porcelain fused to noble metal D6245 - Pontic - porcelain/ceramic D6250 - Pontic - resin with high noble metal D6251 - Pontic - resin with predominantly base metal D6252 - Pontic - resin with noble metal D6253 - Provisional pontic D6545 - Retainer - cast metal for resin bonded fixed prosthesis D6548 - Retainer - porcelain/ceramic for resin bonded fixed prosthesis D6600 - Inlay - porcelain/ceramic, two surfaces D6601 - Inlay - porcelain/ceramic, three or more surfaces D6602 - Inlay - cast high noble metal, two surfaces D6603 - Inlay - cast high noble metal, three or more surfaces D6604 - Inlay - cast predominantly base metal, two surfaces D6605 - Inlay - cast predominantly base metal, three or more surfaces D6606 - Inlay - cast noble metal, two surfaces D6607 - Inlay - cast noble metal, three or more surfaces D6608 - Onlay - porcelain/ceramic, two surfaces D6609 - Onlay - porcelain/ceramic, three or more surfaces D6610 - Onlay - cast high noble metal, two surfaces D6611 - Onlay - cast high noble metal, three or more surfaces D6612 - Onlay - cast predominantly base metal, two surfaces D6613 - Onlay - cast predominantly base metal, three or more surfaces D6614 - Onlay - cast noble metal, two surfaces D6615 - Onlay - cast noble metal, three or more surfaces D6720 - Crown - resin with high noble metal D6721 - Crown - resin with predominantly base metal D6722 - Crown - resin with noble metal D6740 - Crown - porcelain/ceramic D6750 - Crown - porcelain fused to high noble metal D6751 - Crown - porcelain fused to predominantly base metal D6752 - Crown - porcelain fused to noble metal D6780 - Crown - 3/4 cast high noble metal D6781 - Crown - 3/4 cast predominantly base metal D6782 - Crown - 3/4 cast noble metal D6783 - Crown - 3/4 porcelain/ceramic D6790 - Crown - full cast high noble metal D6791 - Crown - full cast predominantly base metal D6792 - Crown - full cast noble metal D6793 - Provisional retainer crown (utilized at least six months) D6920 - Connector bar D6930 - Re-cement fixed partial denture D6950 - Stress breaker D6970 - Cast post and core in addition to bridge D6972 - Cast post as part of bridge D6973 - Core build up for bridge, including any pins D6975 - Coping - metal - to be used as a definitive restoration D6976 - Each additional cast post - same tooth (use with D6970 or D6971) D6977 - Each additional prefabricated post - same tooth (use with D6972) D6980 - Fixed partial denture repair, by report D6985 - Pediatric partial denture, fixed D6999 - Unspecified fixed prosthodontic procedure, by report |
Removable
D5110 - Complete denture - maxillary D5120 - Complete denture - mandibular D5130 - Immediate denture - maxillary D5140 - Immediate denture - mandibular D5211 - Maxillary partial denture - resin base D5212 - Mandibular partial denture - resin base D5213 - Maxillary partial denture - cast metal framework with resin denture bases D5214 - Mandibular partial denture - cast metal framework with resin denture bases D5281 - Removable unilateral partial denture - one piece cast metal D5410 - Adjust complete denture - maxillary D5411 - Adjust complete denture - mandibular D5421 - Adjust partial denture - maxillary D5422 - Adjust partial denture - mandibular D5510 - Repair broken complete denture base D5520 - Repair missing or broken teeth - complete denture D5610 - Repair resin denture base D5620 - Repair cast framework D5630 - Repair or replace broken clasp D5640 - Replace broken teeth - per tooth D5650 - Add tooth to existing partial denture D5660 - Add clasp to existing partial denture D5670 - Replace all teeth and acrylic on cast metal framework (maxillary) D5671 - Replace all teeth and acrylic on cast metal framework (mandibular) D5710 - Rebase complete maxillary denture D5711 - Rebase complete mandibular denture D5720 - Rebase maxillary partial denture D5721 - Rebase mandibular partial denture D5730 - Reline complete maxillary denture (chair side) D5731 - Reline complete mandibular denture (chair side) D5740 - Reline maxillary partial denture (chair side) D5741 - Reline mandibular partial denture (chair side) D5750 - Reline complete maxillary denture (laboratory) D5751 - Reline complete mandibular denture (laboratory) D5760 - Reline maxillary partial denture (laboratory) D5761 - Reline mandibular partial denture (laboratory) D5810 - Interim complete denture (maxillary) D5811 - Interim complete denture (mandibular) D5820 - Interim partial denture (maxillary) D5821 - Interim partial denture (mandibular) D5850 - Tissue conditioning - maxillary D5851 - Tissue conditioning - mandibular D5860 - Over denture - complete, by report D5861 - Over denture - partial, by report D5862 - Precision attachment, by report D5867 - Replacement of replaceable part or semi-precision attachment (male or female component) D5875 - Modification of removable prosthesis following implant surgery D5899 - Unspecified removable prosthodontic procedure, by report D5982 - Surgical Stent D9940 - Occlusal guard, by report D9941 - Fabrication or athletic mouthguard |
