Buildup + crown: complete (phrasing variant)
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D2950 core buildup · tooth #12 · 09/02/2026
Ready to submitNarrative Every sentence checked against the chart
Not enough coronal structure to support the crown, buildup required. Approximately 60% of coronal structure missing after caries removal. A crown (D2740) on #12 is recorded for 09/02/2026, the same visit. Periapical radiograph of #12 taken 06/28/2026. Treatment: D2950 core buildup on tooth #12, date of service 09/02/2026.
Claim note
Buildup #12: narrative and radiograph attached
Attachments
| Item | Status | Detail |
|---|---|---|
| Radiograph | In Open Dental | Periapical radiograph of #12 taken 06/28/2026. Source: Open Dental Imaging: "PA 12 pre-op" (X-Rays), DocNum 18201. |
Documentation checks
| Check | Status | Detail |
|---|---|---|
| Radiograph of tooth #12 within 12 months | Met | Periapical radiograph of #12 taken 06/28/2026 (2.2 months before the date of service). |
| Insufficient remaining structure to retain a crown documented | Met | Not enough coronal structure to support the crown, buildup required. |
| Extent of tooth structure loss documented | Met | Approximately 60% of coronal structure missing after caries removal. |
| Crown on the same tooth | Met | A crown (D2740) on #12 is recorded for 09/02/2026, the same visit. |
Evidence used (5 facts)
| ID | Fact | Where it comes from |
|---|---|---|
| C1 | D2950 core buildup on tooth #12, date of service 09/02/2026. | Procedure D2950 (ProcNum 18001) |
| C2 | Periapical radiograph of #12 taken 06/28/2026. | Open Dental Imaging: "PA 12 pre-op" (X-Rays), DocNum 18201 |
| C3 | A crown (D2740) on #12 is recorded for 09/02/2026, the same visit. | Procedure D2740 completed 09/02/2026 (ProcNum 18002) |
| N1 | Not enough coronal structure to support the crown, buildup required."Not enough coronal structure to support the crown, buildup required" | Clinical note: D2950 #12 on 09/02/2026 (this procedure) |
| N2 | Approximately 60% of coronal structure missing after caries removal."Approx 60% of coronal structure missing after caries removal" | Clinical note: D2950 #12 on 09/02/2026 (this procedure) |
Draft → check → revise loop (1 iteration)
Iteration 1: no issues
Clinical notes read (2, names redacted)
D2950 #12 on 09/02/2026 (this procedure)
Not enough coronal structure to support the crown, buildup required. Approx 60% of coronal structure missing after caries removal.
D2740 #12 on 09/02/2026 (same visit)
Recurrent decay under existing MOD amalgam on #12. Discussed tx options; pt elected zirconia crown. Local anesthetic administered. Prepped #12, final impression taken, temp cemented w/ TempBond.
D2740 crown · tooth #12 · 09/02/2026
Ready to submitNarrative Every sentence checked against the chart
Recurrent decay under existing MOD amalgam on #12. Approximately 60% of coronal structure missing after caries removal. Periapical radiograph of #12 taken 06/28/2026. Treatment: D2740 crown on tooth #12, date of service 09/02/2026.
Claim note
Crown #12: narrative and radiograph 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 | In Open Dental | Periapical radiograph of #12 taken 06/28/2026. Source: Open Dental Imaging: "PA 12 pre-op" (X-Rays), DocNum 18201. |
Documentation checks
| Check | Status | Detail |
|---|---|---|
| Radiograph of tooth #12 within 12 months | Met | Periapical radiograph of #12 taken 06/28/2026 (2.2 months before the date of service). |
| Clinical reason for the crown documented | Met | Recurrent decay under existing MOD amalgam on #12. |
| Extent of tooth structure loss documented | Met | Approximately 60% of coronal structure missing after caries removal. |
| Replacement interval (5+ years since prior crown) | N/A | No prior crown on tooth #12 in the chart. |
| Initial/replacement flag matches chart history | Met | Flagged as initial placement; no prior crown on tooth #12 in the chart. |
| Intraoral photo | Not documented | No intraoral photo of tooth #12 in Open Dental Imaging. |
Evidence used (5 facts)
| ID | Fact | Where it comes from |
|---|---|---|
| C1 | D2740 crown on tooth #12, date of service 09/02/2026. | Procedure D2740 (ProcNum 18002) |
| C2 | Periapical radiograph of #12 taken 06/28/2026. | Open Dental Imaging: "PA 12 pre-op" (X-Rays), DocNum 18201 |
| C3 | Recorded as the initial crown placement on #12. | Procedure D2740: Prosthesis = Initial |
| N1 | Recurrent decay under existing MOD amalgam on #12."Recurrent decay under existing MOD amalgam on #12" | Clinical note: D2740 #12 on 09/02/2026 (this procedure) |
| N2 | Approximately 60% of coronal structure missing after caries removal."Approx 60% of coronal structure missing after caries removal" | Clinical note: D2950 #12 on 09/02/2026 (same visit) |
Draft → check → revise loop (1 iteration)
Iteration 1: no issues
Clinical notes read (2, names redacted)
D2740 #12 on 09/02/2026 (this procedure)
Recurrent decay under existing MOD amalgam on #12. Discussed tx options; pt elected zirconia crown. Local anesthetic administered. Prepped #12, final impression taken, temp cemented w/ TempBond.
D2950 #12 on 09/02/2026 (same visit)
Not enough coronal structure to support the crown, buildup required. Approx 60% of coronal structure missing after caries removal.