Billing and Coding for Resin Composites: What Every Dental Professional Should Know

Published by the American Dental Coders Association

Resin composites — commonly referred to as tooth-colored fillings — are among the most frequently performed procedures in general dentistry. Yet, billing and coding for these restorations can be more complex than they appear. Misuse of CDT codes, lack of proper documentation, and confusion over surfaces and quadrants often lead to denied claims and compliance risks.

This article will walk you through the key CDT codes, documentation requirements, and billing tips to help you accurately code and receive proper reimbursement for composite restorations.

What Are Resin Composites?

Resin composite restorations are used to repair decayed, chipped, or fractured teeth. These materials are bonded to the tooth and shaped to mimic natural tooth structure, providing a more esthetic alternative to traditional amalgam fillings.

CDT Codes for Resin Composite Restorations

The CDT (Current Dental Terminology) includes specific codes for composite restorations based on the number of surfaces treated and the type of tooth involved (anterior vs. posterior).

Anterior Teeth (D2330–D2335):

• D2330 – 1 surface, anterior
• D2331 – 2 surfaces, anterior
• D2332 – 3 surfaces, anterior
• D2335 – 4+ surfaces or involving incisal angle, anterior

Posterior Teeth (D2391–D2394):

• D2391 – 1 surface, posterior
• D2392 – 2 surfaces, posterior
• D2393 – 3 surfaces, posterior
• D2394 – 4+ surfaces, posterior

Key Documentation Requirements

• Tooth number and surfaces involved
• Clinical diagnosis (e.g., caries, fracture)
• Material used (composite)
• Reason for choosing composite (if payer only reimburses for amalgam)
• Pre-op and post-op notes
• Intraoral photographs or radiographs (as required)

Surface Count Tips

• One surface – A single surface like occlusal or facial
• Two surfaces – Examples: MO, DO, or FL
• Three surfaces – Example: MOD
• Four or more surfaces – Include any additional surfaces beyond MOD

Important: Ensure surface count matches documentation to prevent overcoding.

When to Use D2394 or D2335

Use D2394 or D2335 when four or more distinct surfaces are treated. For anterior teeth, D2335 also applies when the incisal angle is involved — even if fewer than four surfaces are restored.

Tip: Always document that the incisal angle was involved when using D2335.

Medical Necessity and Composite vs. Amalgam

Some payers limit reimbursement for posterior composites and may downgrade the procedure to an amalgam equivalent unless:

• There’s a documented allergy to amalgam
• The procedure is medically justified beyond esthetics
• The patient accepts financial responsibility for the difference

Include these details in the clinical notes and obtain written acknowledgment from the patient when needed.

Common Billing Pitfalls to Avoid

• Incorrect surface count
• Using anterior codes for posterior restorations
• Omitting required documentation
• Misrepresenting cosmetic restorations as medically necessary

Cross-Coding with ICD-10

For trauma or medically necessary cases billed through medical insurance, pair the CDT code with accurate ICD-10 diagnosis codes such as:

• K02.9 – Dental caries, unspecified
• S02.5XXA – Fracture of tooth, initial encounter
• K08.89 – Other specified disorders of teeth

Best Practices for Efficient Reimbursement

• Use accurate surface count and tooth number
• Review all documentation prior to claim submission
• Educate your team on CDT coding updates annually
• Inform patients about potential out-of-pocket costs for downgraded procedures
• Include clinical photos and narratives when needed

Get Certified to Code with Confidence

Sharpen your restorative coding skills with expert-led certification from the American Dental Coders Association:

• Certified Dental Billing Specialist (CDBS)
• Certified Dental Coder (CDC)
• Dual Certification Program
• CDBS Exam
• CDC Exam

Final Thoughts

Billing and coding for resin composite restorations may seem straightforward, but getting it right requires attention to detail, up-to-date CDT knowledge, and accurate documentation. With the right training and diligence, your practice can improve reimbursement, reduce denials, and stay compliant.

Stay sharp. Stay certified. And stay supported with resources from the American Dental Coders Association.