Buildup + crown: no radiograph

Claim 17000 · Bluebird Dental Benefits · Date of service 05/31/2026 · Source: synthetic case buildup-04-no-radiograph · Generated 2026-10-12 07:05 UTC

Prepare in Open Dental

Needs documentation

Not ready: 2 items to fix in the chart before this claim goes out. Re-run ClaimClear afterwards.

To-do list as an Open Dental task

ClaimClear: claim 17000 (date of service 05/31/2026), documentation is missing.

D2950 core buildup, tooth #19:
- Attach a pre-operative radiograph of tooth #19 (periapical preferred). If it lives in your imaging software, export it.

D2790 crown, tooth #19:
- Attach a pre-operative radiograph of tooth #19 (periapical preferred). If it lives in your imaging software, export it.

Open Dental API call

POST /tasks
{
  "TaskListNum": 1,
  "UserNum": 1,
  "Descript": "ClaimClear: claim 17000 (date of service 05/31/2026), documentation is missing.\n\nD2950 core buildup, tooth #19:\n- Attach a pre-operative radiograph of tooth #19 (periapical preferred). If it lives in your imaging software, export it.\n\nD2790 crown, tooth #19:\n- Attach a pre-operative radiograph of tooth #19 (periapical preferred). If it lives in your imaging software, export it.",
  "KeyNum": 17000,
  "ObjectType": "Patient"
}

Claim tracking status

ClaimClear: documentation missing, see task

Open Dental API call

POST /claimtrackings
{
  "ClaimNum": 17000,
  "TrackingDefNum": 2,
  "Note": "ClaimClear: documentation missing, see task"
}

ClaimClear never sends claims. After approving, staff attach the narrative PDF and radiographs to the claim in Open Dental and send it as usual.

D2950 core buildup · tooth #19 · 05/31/2026

Needs documentation

Do this before submitting

Attach a pre-operative radiograph of tooth #19 (periapical preferred). If it lives in your imaging software, export it.

Narrative Every sentence checked against the chart

Insufficient tooth structure remaining to retain crown. Approximately 50% of coronal structure missing after caries removal. A crown (D2790) on #19 is recorded for 05/31/2026, the same visit. Treatment: D2950 core buildup on tooth #19, date of service 05/31/2026.

263 characters

Claim note

Buildup #19: narrative attached

Attachments

Item	Status	Detail
Radiograph	Missing	No radiograph of tooth #19 was found in Open Dental Imaging or in completed radiograph procedures.

Documentation checks (Default (common plan guidelines - verify per carrier))

Check	Status	Detail
Radiograph of tooth #19 within 12 months	Missing	No radiograph of tooth #19 was found in Open Dental Imaging or in completed radiograph procedures.
Insufficient remaining structure to retain a crown documented	Met	Insufficient tooth structure remaining to retain crown.
Extent of tooth structure loss documented (recommended)	Met	Approximately 50% of coronal structure missing after caries removal.
Crown on the same tooth	Met	A crown (D2790) on #19 is recorded for 05/31/2026, the same visit.

Evidence used (4 facts)

ID	Fact	Where it comes from
C1	D2950 core buildup on tooth #19, date of service 05/31/2026.	Procedure D2950 (ProcNum 17001)
C2	A crown (D2790) on #19 is recorded for 05/31/2026, the same visit.	Procedure D2790 completed 05/31/2026 (ProcNum 17002)
N1	Insufficient tooth structure remaining to retain crown. "Insufficient tooth structure remaining to retain crown"	Clinical note: D2950 #19 on 05/31/2026 (this procedure)
N2	Approximately 50% of coronal structure missing after caries removal. "Approx 50% of coronal structure missing after caries removal"	Clinical note: D2950 #19 on 05/31/2026 (this procedure)

Draft → check → revise loop (1 iteration)

Iteration 1: no issues

Clinical notes read (2, names redacted)

D2950 #19 on 05/31/2026 (this procedure)

Insufficient tooth structure remaining to retain crown; core buildup placed w/ Fluorocore. Approx 50% of coronal structure missing after caries removal.

D2790 #19 on 05/31/2026 (same visit)

Recurrent decay under existing MOD amalgam on #19. Crown prep #19 for full cast gold crown. Shade A2. Temp placed.

Engine: extractor heuristic, narrator template, reviewer none.

D2790 crown · tooth #19 · 05/31/2026

Needs documentation

Do this before submitting

Attach a pre-operative radiograph of tooth #19 (periapical preferred). If it lives in your imaging software, export it.

Narrative Every sentence checked against the chart

Recurrent decay under existing MOD amalgam on #19. Approximately 50% of coronal structure missing after caries removal. Treatment: D2790 crown on tooth #19, date of service 05/31/2026.

184 characters

Claim note

Crown #19: narrative attached

Would strengthen the claim

Attach an intraoral photo; photos make fracture and decay findings easier for reviewers to accept.

Attachments

Item	Status	Detail
Radiograph	Missing	No radiograph of tooth #19 was found in Open Dental Imaging or in completed radiograph procedures.

Documentation checks (Default (common plan guidelines - verify per carrier))

Check	Status	Detail
Radiograph of tooth #19 within 12 months	Missing	No radiograph of tooth #19 was found in Open Dental Imaging or in completed radiograph procedures.
Clinical reason for the crown documented	Met	Recurrent decay under existing MOD amalgam on #19.
Extent of tooth structure loss documented (recommended)	Met	Approximately 50% of coronal structure missing after caries removal.
Replacement interval (5+ years since prior crown)	N/A	No prior crown on tooth #19 in the chart.
Initial/replacement flag matches chart history	Met	Flagged as initial placement; no prior crown on tooth #19 in the chart.
Intraoral photo (recommended)	Not documented	No intraoral photo of tooth #19 in Open Dental Imaging.

Evidence used (4 facts)

ID	Fact	Where it comes from
C1	D2790 crown on tooth #19, date of service 05/31/2026.	Procedure D2790 (ProcNum 17002)
C2	Recorded as the initial crown placement on #19.	Procedure D2790: Prosthesis = Initial
N1	Recurrent decay under existing MOD amalgam on #19. "Recurrent decay under existing MOD amalgam on #19"	Clinical note: D2790 #19 on 05/31/2026 (this procedure)
N2	Approximately 50% of coronal structure missing after caries removal. "Approx 50% of coronal structure missing after caries removal"	Clinical note: D2950 #19 on 05/31/2026 (same visit)

Draft → check → revise loop (1 iteration)

Iteration 1: no issues

Clinical notes read (2, names redacted)

D2790 #19 on 05/31/2026 (this procedure)

Recurrent decay under existing MOD amalgam on #19. Crown prep #19 for full cast gold crown. Shade A2. Temp placed.

D2950 #19 on 05/31/2026 (same visit)

Insufficient tooth structure remaining to retain crown; core buildup placed w/ Fluorocore. Approx 50% of coronal structure missing after caries removal.

Engine: extractor heuristic, narrator template, reviewer none.