Buildup: no insufficient-structure statement

Claim 15000 · Acme Dental Mutual · Date of service 09/11/2026 · Source: synthetic case buildup-02-no-statement · Generated 2026-10-12 07:07 UTC

Prepare in Open Dental

Needs documentation

Not ready: 1 item to fix in the chart before this claim goes out. Re-run ClaimClear afterwards.

To-do list as an Open Dental task

ClaimClear: claim 15000 (date of service 09/11/2026), documentation is missing.

D2950 core buildup, tooth #4:
- Document that the remaining tooth structure of tooth #4 is insufficient to retain the crown without a buildup, and how much is missing.

Open Dental API call

POST /tasks
{
  "TaskListNum": 1,
  "UserNum": 1,
  "Descript": "ClaimClear: claim 15000 (date of service 09/11/2026), documentation is missing.\n\nD2950 core buildup, tooth #4:\n- Document that the remaining tooth structure of tooth #4 is insufficient to retain the crown without a buildup, and how much is missing.",
  "KeyNum": 15000,
  "ObjectType": "Patient"
}

Claim tracking status

ClaimClear: documentation missing, see task

Open Dental API call

POST /claimtrackings
{
  "ClaimNum": 15000,
  "TrackingDefNum": 2,
  "Note": "ClaimClear: documentation missing, see task"
}

ClaimClear never sends claims. After approving, staff attach the narrative PDF and radiographs to the claim in Open Dental and send it as usual.

D2950 core buildup · tooth #4 · 09/11/2026

Needs documentation

Do this before submitting

Document that the remaining tooth structure of tooth #4 is insufficient to retain the crown without a buildup, and how much is missing.

Narrative Every sentence checked against the chart

A crown (D2750) on #4 is recorded for 09/11/2026, the same visit. Periapical radiograph of #4 taken 08/06/2026. Treatment: D2950 core buildup on tooth #4, date of service 09/11/2026.

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Claim note

Buildup #4: narrative and radiograph attached

Would strengthen the claim

Document the extent of structure loss (e.g., % of the coronal structure missing, cusps lost).

Attachments

Item	Status	Detail
Radiograph	In Open Dental	Periapical radiograph of #4 taken 08/06/2026. Source: Open Dental Imaging: "Periapical 4" (X-Rays), DocNum 15201.

Documentation checks (Default (common plan guidelines - verify per carrier))

Check	Status	Detail
Radiograph of tooth #4 within 12 months	Met	Periapical radiograph of #4 taken 08/06/2026 (1.2 months before the date of service).
Insufficient remaining structure to retain a crown documented	Missing	No note states that the remaining structure of tooth #4 cannot retain a crown without a buildup.
Extent of tooth structure loss documented (recommended)	Not documented	No note quantifies the missing tooth structure of tooth #4.
Crown on the same tooth	Met	A crown (D2750) on #4 is recorded for 09/11/2026, the same visit.

Evidence used (3 facts)

ID	Fact	Where it comes from
C1	D2950 core buildup on tooth #4, date of service 09/11/2026.	Procedure D2950 (ProcNum 15001)
C2	Periapical radiograph of #4 taken 08/06/2026.	Open Dental Imaging: "Periapical 4" (X-Rays), DocNum 15201
C3	A crown (D2750) on #4 is recorded for 09/11/2026, the same visit.	Procedure D2750 completed 09/11/2026 (ProcNum 15002)

Draft → check → revise loop (1 iteration)

Iteration 1: no issues

Clinical notes read (2, names redacted)

D2950 #4 on 09/11/2026 (this procedure)

Core buildup #4 placed w/ Fluorocore. Prepped for crown.

D2750 #4 on 09/11/2026 (same visit)

Recurrent decay under existing MOD amalgam on #4. Discussed tx options; pt elected PFM crown. Local anesthetic administered. Prepped #4, final impression taken, temp cemented w/ TempBond.

Engine: extractor heuristic, narrator template, reviewer none.

D2750 crown · tooth #4 · 09/11/2026

Ready to submit

Narrative Every sentence checked against the chart

Recurrent decay under existing MOD amalgam on #4. Periapical radiograph of #4 taken 08/06/2026. Treatment: D2750 crown on tooth #4, date of service 09/11/2026.

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