Titanium Crown Dental Code (D2794): Full Cast Billing

What D2794 covers

D2794 reports a crown cast entirely from titanium or a titanium alloy and seated on a natural tooth. Full cast means all metal, with no porcelain or ceramic layered on any surface. The code covers the prep, the impression, the lab fabrication, the try-in, and the cementation.

It does not cover:

• A full-cast crown in high noble alloy. That’s D2790.
• A full-cast crown in noble alloy. That’s D2792.
• A full-cast crown in predominantly base-metal alloy. That’s D2791.
• A crown with porcelain fused over a titanium substructure. That’s D2753.
• An all-ceramic crown. That’s D2740.
• A titanium crown on an implant abutment (D6094), on an implant directly (D6088), or serving as a bridge retainer (D6794).
• A core buildup (D2950) or a post and core (D2952 indirectly fabricated, D2954 prefabricated).
• An interim crown (D2799) or recementing an existing one (D2920).

Titanium is not a rung on the noble ladder

Three of the four full-cast crown codes are separated by one measurement: how much noble metal the casting contains by weight. The metals that count toward it are gold plus the platinum group, which the CDT classification of materials lists as platinum, palladium, rhodium, iridium, osmium, and ruthenium. The tiers are fixed.

• D2790, high noble: at least 60% noble metal, of which at least 40% is gold.
• D2792, noble: at least 25% noble metal, with no gold minimum.
• D2791, predominantly base metal: under 25% noble.

D2794 is not the fourth rung on that ladder. It is a separate material category, which is exactly why the ADA gave titanium its own code instead of folding it into one of the other three. Titanium is not a noble metal, and running it through the noble percentages would drop it into the base-metal tier next to the nickel-chromium and cobalt-chromium casting alloys, which is the outcome a separate code exists to prevent.

Titanium is measured, but on a different axis. The CDT classification of materials qualifies a casting as titanium or titanium alloy at 85% or more titanium content, and says nothing about its noble content. That threshold governs D2794 itself, not just its porcelain-layered sibling, so it is the number to look for on the invoice.

That distinction is invisible if you code from the mental model rather than the invoice. A lab invoice that says “titanium alloy” carries no noble percentage, because a noble percentage is not what qualifies the material. An office that reads it, finds no gold, and concludes base metal bills D2791 on a D2794 case.

The full-cast titanium crown and its porcelain twin

The moment porcelain is fused over the titanium, the case leaves the full-cast range and becomes D2753, the porcelain-fused-to-titanium crown. The metal is identical. The construction is not.

The porcelain-fused-to-metal series carries the same alloy split as the full-cast series, titanium included: D2750 for high noble, D2752 for noble, D2751 for predominantly base metal, and D2753 for titanium. So on a titanium case there are exactly two options on a natural tooth, and they are separated by one question: is there porcelain on the outside of it.

The 85% titanium threshold applies to both codes the same way, because it defines the material rather than either procedure. Have it in hand when a lab invoice names a proprietary alloy instead of a composition. If the invoice does not make the titanium content clear, ask the lab before the claim goes out.

Worth knowing about the gaps in the grid, because they generate their own miscodes: the partial-coverage crown family runs D2780 high noble, D2782 noble, D2781 predominantly base metal, and D2783 porcelain and ceramic, with no titanium member. A three-quarter crown in titanium on a natural tooth has no code of its own, so a prep that genuinely is partial coverage in titanium needs a conversation with the carrier rather than a guess at the nearest number. The bridge-retainer side of the book does not have that gap: D6784 reports a three-quarter titanium retainer crown even though the natural-tooth equivalent does not exist.

The implant question, which is a different section of the book

Titanium is the default implant material, so a large share of the titanium restorations an office places are not natural-tooth crowns at all. None of them are D2794.

• Crown on an implant abutment: D6094, abutment-supported titanium crown.
• Crown supported directly by the implant: D6088.
• Retainer crown on a fixed bridge: D6794.

The implant codes sit in a different CDT section with their own benefit design. Many plans run implant services against a separate maximum, a separate waiting period, or a separate exclusion, so an implant case submitted on D2794 does not just get renamed on the EOB. It gets adjudicated against the natural-tooth crown benefit, which is often the wrong pot of money and sometimes the only one that would have paid.

Coverage reality: the family member most likely to be excluded

The three noble-scale codes are ordinary crown benefits on most plans. D2794 is the one that gets left out, and it does so in a way that reads on the EOB like a coding error rather than a plan design.

Two published carrier guides make the pattern concrete. Florida Combined Life’s Standard CDT Guide for 2026 lists D2790, D2791, and D2792 as crowns covered once per tooth per five years on permanent teeth, and lists D2794 as not a covered benefit on both of the plan designs that guide documents. Arkansas Blue Cross Blue Shield’s 2025 dental CDT guide does the same thing: the three noble-scale codes at one in five years, D2794 not a covered benefit. In the Florida standard guide the porcelain-fused-to-titanium code D2753 is covered on the same terms as the other PFM crowns, which puts a covered code and an excluded code on the same metal.

The same carrier’s HCR BlueDental Choice guide is the counterexample, and it is worth reading as a caution against generalizing from one document. There D2794 is covered once per tooth per sixty months on the pediatric plan and not covered on the adult plan, while D2753 runs the opposite way. One carrier, two guides, four different answers on two titanium codes.

None of that is a universal rule. Plenty of plans do pay D2794, and others handle it through an alternate benefit rather than an exclusion. The patterns to expect, all of them plan-dependent and worth confirming against the specific plan:

• Paid as billed. More common on plans that pay by the submitted code without a material clause.
• Alternate-benefit downgrade on a posterior tooth. The plan pays the allowable for a cheaper material, often the base-metal or PFM fee, against the D2794 claim. The EOB shows the billed code with a lower allowed amount.
• Excluded outright. The denial reads as a non-covered service rather than a downgrade, which is a different conversation with the patient and a different collections path.

Frequency and the replacement clock

Crown frequency on this code follows the rest of the crown family. Plans commonly allow one crown per tooth within a window, and five years is the interval published carrier guides name most often, though the length varies by plan and some run longer. A replacement inside the window pends or denies without a narrative explaining what failed on the previous restoration.

Two details make the clock harder to track on titanium than on the others:

• The clock is usually per tooth, not per code. A tooth that had a D2790 crown seated four years ago is inside the window when a D2794 replacement is planned. The material changing does not restart it.
• Many plans count crowns, implant crowns, onlays, and veneers against the same per-tooth allowance. So an earlier onlay on the same tooth can consume the benefit the crown was counting on.

Check the tooth’s history at treatment planning, not at submission.

Documentation: the lab invoice is the proof, not the clinical note

The clinical note establishes that a crown was indicated and seated. It does not establish what the crown was made of. The dentist prepped the tooth and cemented the restoration, but the metal was chosen and mixed at the lab, so the lab’s own paperwork is the only document in the chart that speaks to material with any authority. When a carrier audits a material claim, that is the document it asks for.

Keep in the patient record:

• The lab invoice or work authorization naming the alloy, specifically identifying it as titanium or a titanium alloy. A proprietary brand name alone is thin. If that is all the invoice gives you, ask the lab for the composition in writing and file it alongside.
• Confirmation that the crown is all metal, with no porcelain layer, which is what separates the claim from D2753.
• Prep, impression, and seat dates, with the claim submitted on the seat date.
• The clinical reason for the crown, and the reason titanium was chosen if there was one, such as a documented metal sensitivity. That reason does not change the code, but it answers the medical-necessity question a reviewer asks on an unusual material.
• Any prior restoration on the same tooth and its date, for the frequency review.

When to bill D2794, and when not

Bill D2794 when:

• The lab fabricated a full-cast crown from titanium or a titanium alloy, with no porcelain on any surface.
• The crown was seated on a natural tooth.
• The crown was cemented at the delivery visit, which is the date of service on the claim.

Do not bill D2794 for:

• A titanium crown with porcelain fused over it. Use D2753.
• A crown in high noble, noble, or predominantly base-metal alloy. Use D2790, D2792, or D2791.
• A titanium crown on an implant or abutment. Use D6094 or D6088, or D6794 for a bridge retainer.
• An interim or provisional crown. Use D2799.
• Recementing a crown that is already in place. Use D2920.

What to get right in your PMS

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

1. Give D2794 its own labeled line item, and label it by material rather than by tier. “Full cast crown, titanium” is unambiguous. A fee schedule that lists the four full-cast codes as a tiered ladder invites someone to slot titanium into the cheapest rung.
2. Load a fee for it even if the plan you see most often excludes it. An excluded code still has to go out at the office fee to produce a clean denial and a defensible patient balance. Offices that never set a D2794 fee tend to substitute a code that has one.
3. Keep the full-cast and PFM titanium codes separated by construction. D2794 and D2753 are the same metal, and on at least one carrier’s published guide one is covered and one is not. Labeling both as “titanium crown” is how they get swapped.
4. Flag D2794 for benefit verification before treatment planning. This is the crown code most likely to come back as non-covered, and that is a conversation to have before the prep.
5. Tie the code to the lab invoice in the workflow. Confirm the material from the invoice before the claim goes out, not from the treatment plan written at the prep visit before the case went to the lab.
6. Don’t bundle the buildup or post into D2794. Code D2950, D2952, or D2954 separately on the same claim.