Post and Core In Addition To Crown, Indirectly Fabricated
CDT 2014 descriptor: "Post and core are custom fabricated as a single unit."
The post is the part that extends into the root; the core is the part that replaces anatomic crown structure.
This post is made from scratch.
This post is made indirectly, i.e. outside of the patient's mouth. It involves impressions of the tooth and post space.
The core is part of the post; i.e. it is all one piece.
In most cases, this involves a lab, more than one appointment, and a lab bill.
This post and core is usually made of high noble or noble metals, similar to all-metal crowns.
D2954 - Prefabricated Post and Core In Addition To Crown
CDT 2014 descriptor: "Core is built around a prefabricated post. This procedure includes the core material."
This post is the part that extends into the root; the core is the part that replaces anatomic crown structure.
This post is premade. They are usually ordered in bulk, in various sizes and shapes.
The premade post usually comes with burs that correspond to the shape and size.
The root canal space is prepared for the post, and then the post is cemented in place. A separate core material is placed over/around this premade post.
This is usually done in one appointment.
This usually does not involve impressions of the tooth or post space.
The post might be composed of various metals (such as stainless steel or titanium), or non-metals (such as carbon).
The core can be made of amalgam or bonded composite materials.
Insurance Implications
Some dental offices are confused between these two types of posts, and routinely submit their prefab posts as D2952. They are using an incorrect code, and this could result in investigation, audit, and refund requests by insurance company if it is not documented that a true custom post was done.
Many insurances will only pay D2954 because of contract LEAT (Least Expensive Alternate Treatment) clause that are present in most insurance contracts purchased by employers.
Written by Jacob Hodara
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