As insurance companies tighten policies and increase documentation demands, dental practices are seeing a new twist in the never-ending game of "deny, delay, and downcode."

One of the latest tactics?

Requiring the seat date of the crown in order to unbundle the buildup (D2950) from the crown reimbursement.

If you're not reporting the crown seat date, some payers automatically bundle the buildup with the crown—even when the buildup was clinically necessary and properly documented.

Let’s unpack why this is happening and what you can do to ensure you’re properly reimbursed for both procedures.

What's Going On Behind the Scenes?

In an effort to minimize payouts, some insurers have created policies that flag buildup claims when they don’t clearly occur on a separate date from the final crown seat. Their rationale is:

• If both the buildup and crown seat are performed on the same day, they’re "part of the same restorative event."

• Therefore, the buildup should be considered part of the crown prep and not paid separately.

But clinically, we know that’s often not true.

The buildup is placed to replace missing tooth structure, create retention, and rebuild the core. It’s a separate and essential procedure—even if the final crown is seated on the same day.

The Risk of Not Reporting the Seat Date

If you don't specify a separate seat date, insurers may:

• Automatically bundle the buildup into the crown fee, or

• Deny the buildup altogether for lack of clarity on service sequencing.

This results in:

• Lost revenue (as buildups often reimburse at $100–$200+),

• Extra admin work chasing claims or writing appeals, and

• Frustration for teams trying to do the right thing.

What You Should Do: Best Practices

1. Always Document the Seat Date in Your Chart Notes

Whether the seat date is the same or different from the prep date, make it explicit in your notes:

“Crown prep and buildup performed on [date]. Final crown seated on [seat date].”

Even if both occurred on the same day, clarity matters—especially when you're appealing.

2. Report the Seat Date on the Claim (Even if Not Requested)

Some insurers require it. Others don’t—but adding it anyway helps prevent bundling and speeds up processing.

You can report it:

• In the remarks section of the claim, or

• As a separate narrative attached to the claim:

  “Tooth #30 – Core buildup completed on [date], crown seated on [date]. Buildup placed for retention due to loss of coronal tooth structure.”

3. Submit Buildup and Crown Separately When Appropriate

When possible (especially if the seat date is on a different day), submit the buildup and crown:

• On separate lines of the same claim,

• With separate dates of service, and

• With supporting documentation (radiographs, photos, narrative).

This clarifies that the procedures are distinct and supports payment for both.

4. Have a “Bundling Watchlist”

Create an internal cheat sheet of plans known to:

• Bundle buildups without a seat date,

• Require preauthorization,

• Or routinely deny D2950.

For these plans, be extra vigilant about documenting and reporting seat dates upfront.

5. Appeal If Necessary—With Strong Language

If your buildup gets denied for bundling, submit a written appeal including:

• Clinical narrative explaining the necessity of the buildup,

• A statement that the buildup was performed to provide retention, not as part of the prep,

• The exact dates the buildup and the crown seat occurred,

• Supporting evidence (radiographs, photos).

Sample language:
“The core buildup was placed on [date] to replace missing coronal tooth structure and provide adequate retention for the final crown. The crown was seated on [seat date]. This procedure was clinically and functionally separate from the crown restoration.”

Final Thoughts

Reporting the crown seat date might seem like an extra step, but it can be the difference between getting paid or writing off a medically necessary procedure.

As insurance companies continue to look for ways to cut reimbursement, your best defense is proactive documentation, clear communication, and consistent systems.

By tightening up your crown and buildup protocols now, you protect your practice from bundling denials and ensure you’re fairly paid for the full scope of your care.

Benjamin Tuinei

Founder - Veritas Dental Resources, LLC
Phone: 888-808-4513

Services:
PPO Fee Negotiators | PPO Fee Negotiating | Insurance Fee Negotiating
Insurance Credentialing | Insurance Verifications

Websites:
www.VeritasDentalResources.com | www.VerusDental.com