Crown: complete documentation with intraoral photo
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D2740 crown · tooth #21 · 07/31/2026
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Recurrent decay under existing large amalgam on #21. Buccal and lingual cusps undermined. Periapical radiograph of #21 taken 04/03/2026. Treatment: D2740 crown on tooth #21, date of service 07/31/2026.
Claim note
Crown #21: narrative and radiograph attached
Attachments
| Item | Status | Detail |
|---|---|---|
| Radiograph | In Open Dental | Periapical radiograph of #21 taken 04/03/2026. Source: Open Dental Imaging: "PA 21 pre-op" (Radiographs), DocNum 2201. |
| Intraoral photo | Optional | Intraoral photograph of #21 taken 07/21/2026. Source: Open Dental Imaging: "Intraoral photo #21" (Photos), DocNum 2202. |
Documentation checks
| Check | Status | Detail |
|---|---|---|
| Radiograph of tooth #21 within 12 months | Met | Periapical radiograph of #21 taken 04/03/2026 (3.9 months before the date of service). |
| Clinical reason for the crown documented | Met | Recurrent decay under existing large amalgam on #21. |
| Extent of tooth structure loss documented | Met | Buccal and lingual cusps undermined. |
| Replacement interval (5+ years since prior crown) | N/A | No prior crown on tooth #21 in the chart. |
| Initial/replacement flag matches chart history | Met | Flagged as initial placement; no prior crown on tooth #21 in the chart. |
| Intraoral photo | Met | Intraoral photograph of #21 taken 07/21/2026. |
Evidence used (6 facts)
| ID | Fact | Where it comes from |
|---|---|---|
| C1 | D2740 crown on tooth #21, date of service 07/31/2026. | Procedure D2740 (ProcNum 2001) |
| C2 | Periapical radiograph of #21 taken 04/03/2026. | Open Dental Imaging: "PA 21 pre-op" (Radiographs), DocNum 2201 |
| C3 | Intraoral photograph of #21 taken 07/21/2026. | Open Dental Imaging: "Intraoral photo #21" (Photos), DocNum 2202 |
| C4 | Recorded as the initial crown placement on #21. | Procedure D2740: Prosthesis = Initial |
| N1 | Recurrent decay under existing large amalgam on #21."Recurrent decay under existing large amalgam on #21" | Clinical note: D2740 #21 on 07/31/2026 (this procedure) |
| N2 | Buccal and lingual cusps undermined."buccal and lingual cusps undermined" | Clinical note: D2740 #21 on 07/31/2026 (this procedure) |
Draft → check → revise loop (1 iteration)
Iteration 1: no issues
Clinical notes read (1, names redacted)
D2740 #21 on 07/31/2026 (this procedure)
Recurrent decay under existing large amalgam on #21. buccal and lingual cusps undermined. Crown prep #21 for zirconia crown. Shade A2. Temp placed.
Other procedures on this claim
- D0140