Crown: existing crown charted without a date

Claim 8000 · Bluebird Dental Benefits · Date of service 07/30/2026 · Source: synthetic case crown-08-undated-prior · Generated 2026-10-12 07:05 UTC

Prepare in Open Dental

Needs documentation

Not ready: 1 item to fix in the chart before this claim goes out. Re-run ClaimClear afterwards.

To-do list as an Open Dental task

ClaimClear: claim 8000 (date of service 07/30/2026), documentation is missing.

D2790 crown, tooth #14:
- Enter the original placement date on the procedure (Prosthesis: Replacement, with the original date).

Open Dental API call

POST /tasks
{
  "TaskListNum": 1,
  "UserNum": 1,
  "Descript": "ClaimClear: claim 8000 (date of service 07/30/2026), documentation is missing.\n\nD2790 crown, tooth #14:\n- Enter the original placement date on the procedure (Prosthesis: Replacement, with the original date).",
  "KeyNum": 8000,
  "ObjectType": "Patient"
}

Claim tracking status

ClaimClear: documentation missing, see task

Open Dental API call

POST /claimtrackings
{
  "ClaimNum": 8000,
  "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.

D2790 crown · tooth #14 · 07/30/2026

Needs documentation

Do this before submitting

Enter the original placement date on the procedure (Prosthesis: Replacement, with the original date).

Narrative Every sentence checked against the chart

Patient presents with fractured ML cusp on #14. Patient reports pain on biting. Periapical radiograph of #14 taken 04/19/2026. Treatment: D2790 crown on tooth #14, date of service 07/30/2026.

191 characters

Claim note

Crown #14: 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 #14 taken 04/19/2026. Source: Open Dental Imaging: "Periapical 14" (X-Rays), DocNum 8201.

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

Check	Status	Detail
Radiograph of tooth #14 within 12 months	Met	Periapical radiograph of #14 taken 04/19/2026 (3.4 months before the date of service).
Clinical reason for the crown documented	Met	Patient presents with fractured ML cusp on #14.
Extent of tooth structure loss documented (recommended)	Met	Patient presents with fractured ML cusp on #14.
Replacement interval (5+ years since prior crown)	Missing	The chart shows a prior crown on tooth #14 but no placement date. Payers ask for the prior placement date on replacement crowns.
Initial/replacement flag matches chart history	N/A	Procedure is not flagged as an initial placement.
Intraoral photo (recommended)	Not documented	No intraoral photo of tooth #14 in Open Dental Imaging.

Evidence used (6 facts)

ID	Fact	Where it comes from
C1	D2790 crown on tooth #14, date of service 07/30/2026.	Procedure D2790 (ProcNum 8001)
C2	Periapical radiograph of #14 taken 04/19/2026.	Open Dental Imaging: "Periapical 14" (X-Rays), DocNum 8201
C3	The chart records an existing crown on #14; its placement date is not recorded.	Existing procedure D2750 charted 05/01/2019 (ProcNum 8002)
N1	Patient presents with fractured ML cusp on #14. "Pt presents w/ fractured ML cusp on #14"	Clinical note: D2790 #14 on 07/30/2026 (this procedure)
N2	Patient presents with fractured ML cusp on #14. "Pt presents w/ fractured ML cusp on #14"	Clinical note: D2790 #14 on 07/30/2026 (this procedure)
N3	Patient reports pain on biting. "Pt reports pain on biting"	Clinical note: D2790 #14 on 07/30/2026 (this procedure)

Draft → check → revise loop (1 iteration)

Iteration 1: no issues

Clinical notes read (1, names redacted)

D2790 #14 on 07/30/2026 (this procedure)

Pt presents w/ fractured ML cusp on #14. Approx 70% of coronal tooth structure missing. Pt reports pain on biting. Crown prep #14 for full cast gold crown. Shade A2. Temp placed.

Engine: extractor heuristic, narrator template, reviewer none.