D2335 is the CDT code for a resin-based composite restoration on an anterior tooth that covers four or more surfaces, or any restoration involving the incisal angle. It applies to the upper and lower incisors and canines. This code covers large anterior composites and all Class IV restorations.
Get help with D2335 claims →Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Any restoration that repairs or replaces the incisal corner or angle of an anterior tooth. Incisal angle involvement triggers D2335 regardless of total surface count.
An anterior composite that genuinely involves four or more distinct tooth surfaces. Document each surface in the chart. Surface count must match the billed code.
Applies to incisors and canines (teeth 6-11, 22-27). For four-or-more-surface posterior composites, use D2394. Surface-based codes differ by arch position.
Do NOT use D2335 for: Posterior teeth, even canines in some plans that reclassify them as posterior. Three-surface anterior composites (use D2332). Two-surface anterior composites (use D2331). Single-surface anterior composites (use D2330). Posterior composites regardless of surface count (use D2391 through D2394).
The most common audit trigger for composite codes is a mismatch between the surfaces billed and the surfaces charted. If the clinical note says "mesial-incisal" but you bill D2335, a reviewer will flag it. Each surface involved in the preparation and restoration must be explicitly named in the chart entry. Incisal angle involvement should be documented as a separate clinical finding, not just implied by the code.
Most plans limit composite replacements to once every one to three years per tooth surface. If a composite was placed on the same tooth recently, the plan may deny based on frequency even when the new restoration is clinically justified. Check the patient's history. When clinical need overrides the frequency limitation, submit a narrative with supporting documentation.
Some plans reimburse anterior composites at the amalgam rate and bill the patient the difference. This isn't a denial, but if you don't inform the patient before treatment, it creates a billing dispute. Many plans now cover anterior composites at composite rates, but verify the specific plan benefit. The Affordable Care Act does not prohibit amalgam downgrades for adults.
A current periapical or bitewing radiograph showing the affected tooth is standard supporting documentation. When radiographic evidence of decay is absent, for example a purely traumatic fracture, an intraoral photo or a clear clinical note describing the fracture extent is the substitute. Submit photos when available. They reduce denial rates on Class IV claims.
Name every surface involved: mesial, distal, facial, lingual, incisal. For incisal angle involvement, note it explicitly. The code must match the surfaces documented.
A periapical x-ray showing decay extent, or an intraoral photo of the fracture or defect. For Class IV fractures, a photo showing the missing incisal corner is often clearer than a radiograph.
State the diagnosis: carious lesion, fracture, failing existing restoration. Explain why the restoration size warrants D2335 rather than a lesser code. Clinical notes should tell the story the radiograph can't.
Claim must include the correct tooth number (universal system) and surface codes. Surface codes on the claim must match the clinical chart. Any discrepancy is grounds for denial.
Note the composite material used and shade selected. Not required by every payer, but consistent documentation supports the clinical record and reduces audit exposure.
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Learn about our billing servicesD2335 is the CDT code for a resin-based composite restoration on an anterior tooth covering four or more surfaces, or any restoration involving the incisal angle. It applies to incisors and canines.
Upper and lower incisors and canines, corresponding to teeth 6 through 11 and 22 through 27 in the universal numbering system. Premolars are posterior and use the D239X codes.
D2331 is for two-surface anterior composites. D2335 is for four or more surfaces, or any restoration involving the incisal angle. D2332 covers three surfaces. The surface count and incisal angle involvement determine the right code.
Common reasons: surface count mismatch between claim and chart, frequency limitations, missing radiograph or photo, and plans that downgrade to amalgam reimbursement rates.
Yes. A Class IV restoration by definition involves the incisal angle. D2335 is the correct code for all Class IV anterior composites regardless of how many other surfaces are included.
Most plans do not require pre-auth for composite fillings. Large anterior restorations may be flagged for review. When uncertain, submit pre-auth with a photo and radiograph before starting treatment.
Search all CDT codes in our dental coding guide.