Belle DuCharme

CDPMA, Dental Training Consultant

Code Tip: D2961 Labial Veneer (Resin Laminate)-Laboratory (Indirect resin bonded veneers)

Indirect refers to fabrication from a lab and direct refers to fabrication at chairside on the patient.  Do not report D2961 for laboratory made or CAD/CAM porcelain/ceramic veneers. Resin materials such as Belleglass® and Concept® are not to be confused with porcelain veneers cast in a laboratory. 

Take note that the code descriptor for a veneer has been changed to include prepping into the mesial and distal interproximal surfaces and covering an incisal edge.  It is more appropriate to report a D2962 veneer on a virgin tooth if it only extends to the interproximal.

It is wrong to report a D2783 (a “reverse” 3⁄4 crown) on a tooth that is virgin to get reimbursement at a higher level. Especially now that the code D2961 and D2962 includes some prepping into the distal and mesial.  A D2783 requires a much more aggressive prep and is often the code of choice for teeth that have had previous interproximal composite restorations that are failing.

Often denied for “cosmetic” reasons, a labial veneer can be a covered expense with a proper narrative and intra-oral photos, to support radiographs, that display cracks, craze lines, washed out restorations and decay.  Make sure to label the attachments correctly and indicate where the pathology/evidence is located on the tooth/teeth. Include in the narrative the time, material expense and skills necessary to perform the service. 

Dental Billing Tips and News for Pros; Edition #143


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