D2391 dental code: resin composite one surface posterior.

D2391 is for a resin-based composite (tooth-colored) filling on one surface of a posterior tooth. Posterior means premolars and molars. One surface means the filling involves only one tooth surface: occlusal, mesial, distal, buccal, or lingual. This is one of the most commonly billed codes in general dentistry.

Code
D2391
Category
Restorative
Coverage
Basic (70-80%)

When to use D2391

D2391 is for a resin-based composite (tooth-colored) filling on one surface of a posterior tooth. Posterior means premolars and molars. One surface means the filling involves only one tooth surface: occlusal, mesial, distal, buccal, or lingual. This is one of the most commonly billed codes in general dentistry.

2026 CDT update: The D2391 descriptor was revised for CDT 2026. The previous language restricted D2391 to lesions penetrating into dentin. That restriction has been removed. D2391 now applies to any one-surface posterior composite regardless of lesion depth or diagnosis. D1352 (preventive resin restoration) was deleted because D2391 now covers that procedure. If your practice was billing D1352, switch to D2391.

Do NOT use D2391 for: Anterior composite fillings (use D2330-D2332). Multi-surface posterior composites (use D2392 for two surfaces, D2393 for three, D2394 for four or more). Amalgam fillings (use D2140-D2161).

D2391 vs similar codes

Click any code to see the difference.

D2391
Resin composite one surface posterior

One surface posterior composite. Single surface involved (e.g., occlusal only).

Two surface posterior composite. Two surfaces involved (e.g., mesio-occlusal or disto-occlusal).

Why D2391 claims get denied

Amalgam downgrade

Many PPO plans downgrade posterior composites to amalgam reimbursement. The claim isn't denied but it's paid at the D2140 (amalgam) rate. The patient is responsible for the difference. Inform patients about downgrades before treatment so there are no billing surprises.

Surface count discrepancy

Billing D2392 (two surfaces) when only one surface was treated triggers an audit. Document the surfaces involved precisely. If the prep extends into a second surface, document it. If it doesn't, bill D2391.

Replacing a recent restoration

Some plans have a waiting period or replacement limitation. If the tooth had a filling within the last 6-24 months, the replacement may be denied. Document why replacement is necessary.

Documentation checklist for D2391

Surfaces documented

Specify exactly which surface: occlusal, mesial, distal, buccal, lingual. The surface designation must match the code.

Diagnosis

Document caries, fracture, or defective existing restoration. Reason for the filling.

Pre-operative radiograph

Bitewing or periapical showing the caries or pathology. Not always required but supports the claim if questioned.

Material

Resin composite. If you placed amalgam, use D2140 instead.

Payer-specific downgrade policies

Delta Dental PPO commonly downgrades posterior composites to amalgam reimbursement. Delta Dental Premier plans may or may not downgrade depending on the specific plan. The reimbursement difference on a one-surface filling can be $30-60. Always check whether the patient's specific plan applies a downgrade before presenting treatment costs.

The alternate benefit clause. Payers that downgrade are using an "alternate benefit" or "least expensive alternative treatment" clause. They acknowledge that composite is an acceptable material but only pay for what they consider the least expensive clinically acceptable option. The clause is in the patient's plan documents. You can't fight it with a narrative. It's a plan design decision, not a clinical denial.

CDT 2026 impact on D2391 billing. With the deletion of D1352 and the revision of D2391's descriptor, practices that previously used D1352 for conservative resin restorations on incipient lesions should now use D2391. If your PMS still has D1352 as an active code, update it. Claims submitted with D1352 in 2026 will be denied automatically.

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Related codes

D2392Resin composite two surfaces posterior
D2393Resin composite three surfaces posterior
D2394Resin composite four+ surfaces posterior
D2140Amalgam one surface
D2330Resin composite one surface anterior

D2391 FAQ

What is D2391?

D2391 is the CDT code for a one-surface resin composite filling on a posterior tooth (premolar or molar).

Do insurance plans downgrade D2391 to amalgam?

Many PPO plans reimburse posterior composites at the amalgam rate. The patient pays the difference between composite and amalgam fees.

What is the difference between D2391 and D2392?

D2391 is one surface. D2392 is two surfaces. The number of tooth surfaces involved determines the code.

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