D2790 is the CDT code for a crown made entirely of high noble metal with no porcelain. High noble metal means at least 60 percent noble metal by weight with at least 40 percent gold. These are all-metal crowns used where durability takes priority over aesthetics.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Get help with D2790 claims →Use D2790 when placing a full cast crown made entirely of high noble metal. The ADA defines high noble metal as an alloy containing at least 60 percent noble metal content by weight, with a minimum of 40 percent gold. The alloy classification comes from the dental lab documentation, not from the dentist's assumption.
Common clinical scenarios: Posterior teeth where minimal tooth reduction is desired and aesthetics are not a priority. Teeth with significant parafunctional wear patterns where a metal crown offers superior durability. Pediatric or geriatric cases where a full metal crown is clinically preferred. Situations where the patient's opposing teeth would benefit from the wear characteristics of metal.
Do NOT use D2790 for: Crowns with any porcelain overlay (use D2750 for high noble PFM). Crowns made with base metal (use D2791). Crowns made with noble metal at lower percentages than high noble (use D2792). Crown retainers on bridge abutments (use D6790). Implant-supported crowns (different code series).
The most common coding error with full cast metal crowns is billing the wrong metal classification. D2790 requires high noble metal (60%+ noble, 40%+ gold). If the lab used a base metal alloy or a noble alloy that falls below the high noble threshold, D2790 is the wrong code. Always verify the alloy classification on the lab slip before billing.
Crown replacement within the plan's frequency window is one of the most common denial reasons. Most plans limit crown replacement to once every 5 to 7 years on the same tooth. Review the patient's history and the plan's rules. Submit a narrative with supporting clinical evidence if replacement is medically necessary within the limitation period.
Many plans require pre-auth before crown treatment begins. Submitting the claim after treatment without prior authorization often results in denial or reduced payment. Verify pre-auth requirements for each patient's plan and submit radiographs and clinical notes with the pre-auth request.
A claim without clear radiographic and narrative support is vulnerable on review. Document the diagnosis, why full coverage is indicated, and why the patient received a full cast metal crown rather than a ceramic or PFM option. Clinical notes should match the code billed.
Periapical or bitewing showing the condition requiring full coverage: extent of decay, fracture, failing restoration, or post-endodontic status. The x-ray supports the medical necessity for a crown.
The lab slip or alloy report confirming the metal meets high noble classification (at least 60% noble, at least 40% gold). This is what justifies D2790 versus D2791 or D2792. Keep this documentation in the patient file.
Document the specific clinical indication for full coverage and for full cast metal. Note the tooth number and that the restoration is a standalone crown (not part of a bridge).
Check the plan before treatment. Submit pre-auth with radiographs and clinical notes. Document the authorization number in the patient record and include it on the claim.
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Learn about our billing servicesD2790 is the CDT code for a full cast crown made entirely of high noble metal. High noble metal contains at least 60 percent noble metal by weight with at least 40 percent gold. No porcelain is used. These crowns are used primarily on posterior teeth where function takes priority over aesthetics.
D2790 is a full cast metal crown with no porcelain. D2750 is a porcelain-fused-to-high-noble-metal crown (PFM). Both use high noble metal, but D2750 has porcelain coverage on the visible surfaces and D2790 is entirely metal.
D2790 uses high noble metal (at least 60% noble, at least 40% gold). D2791 uses predominantly base metal. The alloy composition documented by the dental lab determines which code applies. Using the wrong code based on assumed alloy content is a common billing error.
Common reasons include metal classification mismatch between the lab alloy and the billed code, frequency limitations, missing pre-authorization, and insufficient clinical documentation supporting the need for full coverage.
Pre-operative radiograph, lab alloy documentation confirming high noble classification, clinical notes with the diagnosis and rationale for full cast metal, and pre-authorization if required by the patient's plan.
Most dental plans cover full cast metal crowns as a major service, typically at 50 percent after the deductible with frequency limitations. Metal crowns on posterior teeth are generally considered an appropriate standard of care. Check the patient's specific plan for details.
Search all 206 CDT codes in our dental coding guide.