PDA

View Full Version : Difference between big filling vs. Crown buildup


nasw
May 19, 2009, 04:45 PM
Hi,
My new dentist told me I needed a big filling (and a small filling, a crown, an extraction and
Bridge or implant). Almost all the work's been done, during these visits he referred to doing a "big filling" that would stave off needing a crown on that tooth for years. But when the time came he did a "crown buildup." By the way he talked about it, I thought it was the same thing; he charges the same for both. However, my insurance company paid only 50% for the crown buildup whereas they pay 80% for fillings. When I spoke to my insurance and told them no crown was placed and there were no plans for one, they said I should have the dentist change the claim and resubmit it.
1) Is that a big deal for the dentist to do? (Would I be suggesting something "unethical"?)
2) What if any is the difference in how a big filling (composite) vs. a crown buildup are done
And how they function?

Many thanks for your help!

Amir1981
May 19, 2009, 05:01 PM
It can be the same thing. A core usually takes less time since it can just be a blob of filling that is to be cut down later... ask him to resubmit it, It's not unethical from my point of view

flossie
May 19, 2009, 07:50 PM
If the dentist does not plan on placing a crown then he did a 5 surface filling. When a crown is planned it is called a core build up. There are two different codes I believe. Have the dentist resubmit for the filling code. I'm sure it must have been an oversight on whoever posted the treatment. Not an unethical request at all.

There is no real difference between a large composite and a build up (core) for a crown. Both can be done in either composite or amalgam. Perhaps the filling might be a little more time consuming since it is not going to be reduced in order for a crown to fit over it.