D2792 Dental Code: Full Cast Noble Metal Crown Billing

What D2792 covers

D2792 reports a full-cast crown made entirely of noble metal alloy. Full cast means the crown is all metal, with no porcelain or ceramic on any surface. Noble metal means the alloy meets the middle tier of the ADA’s casting-alloy classification: at least 25% noble metal content by weight, but below the high noble threshold.

The code covers the prep, the impression, the lab fabrication, the try-in, and the cementation. It does not include a separate core buildup, a post, or the bite registration as its own charge.

It does not cover:

• A full-cast crown made of high noble alloy. That’s D2790.
• A full-cast crown made of predominantly base-metal alloy. That’s D2791.
• A full-cast crown made of titanium or titanium alloy. That’s D2794.
• A porcelain-fused-to-noble-metal crown. That’s D2752.
• A core buildup. That’s D2950.
• A post and core. That’s D2952 (indirectly fabricated) or D2954 (prefabricated).

The distinguishing axis: noble metal percentage, not the tooth

This is the thing most often gotten wrong on the full-cast crown codes, and it has nothing to do with which tooth got the crown or how the crown looks.

There are four full-cast crown codes. They are identical except for one variable: the alloy class, defined by how much noble metal the casting contains.

• D2790 is the high noble alloy: at least 60% noble metal with at least 40% gold.
• D2792 is the noble alloy: at least 25% noble metal, but below the high noble cutoff.
• D2791 is predominantly base metal: under 25% noble metal.
• D2794 is titanium and titanium alloys, a separate material category.

The noble metals counted toward the percentage are gold, palladium, and platinum (the classification also recognizes rhodium, ruthenium, iridium, and osmium, which rarely show up in crown alloys). D2792 is the in-between code: more noble metal than a base-metal casting, less than a high noble one. A crown is not coded D2792 because it sits on a back tooth or because the metal looks pale. It is coded D2792 because the lab invoice shows an alloy in the noble tier.

Full cast versus porcelain fused: the other place it gets miscoded

The full-cast codes report all-metal crowns. The moment any porcelain is fused to the metal, the crown moves out of the D2790 to D2794 range and into the porcelain-fused-to-metal series.

The PFM series mirrors the same alloy classes. D2752 is porcelain fused to noble metal, the porcelain counterpart to D2792’s all-metal noble crown. Both use a noble alloy, so the noble percentage is identical between them. The difference is whether porcelain was layered onto the metal.

So a noble-alloy crown can be a D2792 case or a D2752 case. The deciding question is the construction, not the metal. All metal with no porcelain is full cast (D2792). Metal with porcelain fused over it is PFM (D2752). Carriers pay these at different fees, so the construction has to match the code.

Coverage reality: the noble crown is a downgrade magnet

A full-cast noble crown sits in an awkward spot for plan adjudication. It costs more than a base-metal casting but is functionally a posterior all-metal crown, and that is exactly the kind of claim plans write alternate-benefit rules around. How any given plan handles it varies, so treat the patterns below as things to verify, not as rules.

Common plan approaches on a D2792 claim:

• Pay D2792 at the full benefit. More likely on older indemnity-style plans that pay by the billed code.
• Downgrade to the base-metal fee (D2791). A plan pays the predominantly base-metal allowed amount against the D2792 claim, on the reasoning that any full-cast crown delivers the same function regardless of alloy cost. The patient owes the difference.
• Apply a posterior crown downgrade. Some plans downgrade posterior crowns to a standard material allowance regardless of what was placed, paying a set amount and leaving the balance to the patient.

A downgrade is plan design, not a denial, and there is no appeal that overturns it. The EOB shows the billed code, the allowed amount, the plan’s percentage, and the patient balance. The collections work is on the patient-side balance, which is why the conversation belongs at treatment planning.

Some plans also exclude full-cast crowns entirely and cover only PFM or all-ceramic. On those, the denial reads as a non-covered service and the patient owes the full fee. Confirm the plan’s crown rules, including any alloy-based downgrade, before the prep.

When to bill D2792

Bill D2792 when:

• The lab fabricates a full-cast crown, all metal with no porcelain.
• The alloy is in the noble tier: the lab invoice confirms at least 25% noble metal and less than the high noble threshold.
• The crown is seated and cemented at the delivery visit.

Do not bill D2792 for:

• A high noble alloy crown. Use D2790.
• A predominantly base-metal alloy crown. Use D2791.
• A titanium or titanium-alloy crown. Use D2794.
• A crown with porcelain on any surface. Use the PFM series, such as D2752 for noble metal.
• A provisional or temporary crown. Use D2799 (interim crown).
• Recementing an existing crown. Use D2920.

Documentation that supports the claim

The claim needs:

• Date of service for the seat (delivery) visit, not the prep visit. The fee covers the completed restoration.
• Tooth number.
• The alloy confirmation when the carrier requests it, which means the lab invoice showing noble metal content.
• A narrative when the crown is a remake inside the carrier’s frequency window, citing the clinical reason (fractured original, defective margin, recurrent decay under the old crown).

For the patient record, keep:

• The lab invoice with the alloy composition. On a noble-tier crown this is the single most important document, because D2792 is the code most likely to be questioned on alloy content.
• The prep, impression, and seat dates.
• The clinical reason for the crown.
• Any prior crown on the same tooth and its placement date, in case of a frequency review.

What to get right in your PMS

The menus differ across Open Dental, Dentrix, Eaglesoft, Curve, and Carestream, but the setup that prevents problems is the same.

1. Keep all four full-cast codes as distinct, clearly labeled line items. D2790 (high noble), D2792 (noble), D2791 (base metal), and D2794 (titanium) should each be their own entry, so the alloy class is a deliberate pick and not a default. The full-cast crown family has a long history of being miscoded by one alloy tier, and a fee schedule that blurs them invites the same error.
2. Tie the code to the lab invoice in the workflow. Confirm the noble percentage on the invoice before the claim goes out. If your process bills the crown code at the prep visit before the lab work is back, you can end up with the wrong alloy code on the claim.
3. Bill at the seat visit, not the prep visit. Submitting at the prep is a common error that gets the claim rejected or pended.
4. Set the patient estimate to expect a possible downgrade. Where the plan downgrades a noble crown to a base-metal or PFM allowance, the estimate should reflect the likely patient balance, not the full D2792 fee. Have that conversation at treatment planning.
5. Don’t bundle the buildup or post into D2792. Code D2950, D2952, or D2954 separately on the same claim.
6. Keep the lab invoice in the patient record for the carrier’s audit window. Most plans audit crown material claims back several years, and the exact window is plan-dependent.