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, impression, lab fabrication, try-in, and cementation. The date of service is the seat visit.

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 or serving as a bridge retainer. Those are implant and fixed prosthodontic codes, covered below.
• A core buildup (D2950) or a post and core (D2952 indirectly fabricated, D2954 prefabricated). Code these separately on the same claim.
• 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 how much noble metal the casting contains by weight. The metals that count are gold plus the platinum group, which the CDT classification of materials lists as platinum, palladium, rhodium, iridium, osmium, and ruthenium.

• 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 a separate material category, which is why the ADA gave titanium its own code. Titanium is not a noble metal, and running it through the noble percentages would drop it into the base-metal tier next to nickel-chromium and cobalt-chromium, the outcome the separate code exists to prevent.

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

The full-cast titanium crown and its porcelain twin

Once 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. On a natural tooth, a titanium case has exactly two options, separated by whether there is porcelain on the outside.

The 85% titanium threshold applies to both codes, because it defines the material rather than the procedure. If the invoice names a proprietary alloy without making the titanium content clear, ask the lab before the claim goes out.

The grid has gaps that cause 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 titanium crown on a natural tooth has no code, so a genuinely partial-coverage titanium prep needs a conversation with the carrier rather than a guess at the nearest number. The bridge-retainer side has no such gap: D6784 reports a three-quarter titanium retainer crown.

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

Titanium is the default implant material, so many of the titanium restorations an office places are not natural-tooth crowns. 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, waiting period, or exclusion. An implant case submitted on D2794 is not just renamed on the EOB; it is 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 the exclusion reads on the EOB like a coding error rather than plan design.

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 plan designs it documents. In the same guide, the porcelain-fused-to-titanium code D2753 is covered on the same terms as the other PFM crowns, so one titanium code is covered and the other excluded. Arkansas Blue Cross Blue Shield’s 2025 dental CDT guide follows the same pattern: the three noble-scale codes at one in five years, D2794 not a covered benefit.

The same carrier’s HCR BlueDental Choice guide is the counterexample. 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. Read the guide that governs the plan, not the carrier’s name.

Many plans do pay D2794. The plan-dependent patterns to confirm:

• 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. The EOB shows the billed code with a lower allowed amount.
• Excluded outright. The denial reads as a non-covered service, which is a different patient conversation and a different collections path.

Verify D2794 coverage before treatment planning; it is the crown code most likely to come back as non-covered.

Frequency and the replacement clock

Crown frequency on D2794 follows the rest of the crown family. Plans commonly allow one crown per tooth within a window. Five years is the interval published carrier guides name most often, though it varies and some plans 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:

• 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. Changing the material does not restart it.
• Many plans count crowns, implant crowns, onlays, and veneers against the same per-tooth allowance. An earlier onlay on the same tooth can use up 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 shows that a crown was indicated and seated. It does not show what the crown was made of. The metal was chosen at the lab, so the lab’s paperwork is the only document in the chart that speaks to material with authority, and it is what a carrier asks for on a material audit. Confirm the material from the invoice before the claim goes out, not from the treatment plan written before the case went to the lab.

Keep in the patient record:

• The lab invoice or work authorization naming the alloy as titanium or a titanium alloy. A proprietary brand name alone is thin; if that is all the invoice gives, ask the lab for the composition in writing and file it alongside.
• Confirmation that the crown is all metal, with no porcelain layer, which 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. It 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.

Setting up D2794 in the fee schedule

• Label D2794 by material, not 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.
• Load a fee 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.
• Separate the full-cast and PFM titanium codes by construction. D2794 and D2753 are the same metal, and at least one carrier’s published guide covers one and not the other. Labeling both “titanium crown” is how they get swapped.