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MEDICAL POLICY SUBJECT: DENTAL CROWNS AND VENEERSEFFECTIVE DATE: 04/24/14 REVISED DATE: 04/23/15, 04/28/16, 06/22/17POLICY NUMBER: 13.01.02 CATEGORY: Dental PAGE: 1 OF: 3 If a product excludes coverage
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Subject dental crowns are a type of dental restoration that is used to cover or cap a damaged tooth.
Dentists or dental professionals who perform dental crown procedures are required to file subject dental crowns.
To fill out subject dental crowns, the dental professional must provide information on the patient, the type of dental crown used, the date of the procedure, and any complications or follow-up care needed.
The purpose of subject dental crowns is to restore the function and appearance of a damaged tooth, as well as to protect it from further damage.
Information such as patient demographics, type of dental crown used, date of procedure, any complications, and follow-up care must be reported on subject dental crowns.
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