Prior Authorization Requirements for Porcelain Crowns

ForwardHealth has updated prior authorization (PA) requirements for the recently added Current Dental Terminology procedure codes D2740 (Crown – porcelain/ceramic) and D2751 (Crown – porcelain fused to predominantly base metal).

Providers might need to submit a PA request for porcelain crowns when: 

• A member needs four or more crowns within 12 months of the member’s most recent examination.
• They are replacing an existing crown.
• They have successfully completed root canal therapy.
• They are unsure of a member’s dental history.

Providers are encouraged to coordinate with the member’s previous dental offices to obtain records as necessary. Please reach out to Provider Services if you have additional questions.

Note: These codes aren’t listed on the Prior Authorization/Dental Attachment 1 (PA/DA1), F-11010 (01/2019), so providers should manually add them to Section IV (Additional Information) of this form. 

Refer to the FAQs on the Resources for Dentists page of the ForwardHealth Portal (the Portal) for more information about completing Section IV of the PA/DA1.

Providers will be alerted when new forms are available for use. Providers can find all forms on the Forms page of the Portal.