Navigating Cigna Dental Insurance Downgrades: A Comprehensive Guide to Unraveling Complexities.
Published on January 22, 2024
As the cost of dental services continues to soar, dental insurance policies are implementing downgrades or fee reductions, particularly for expensive procedures. This comprehensive exploration delves into crucial information gathered from major dental insurance providers, focusing on Cigna Dental. We shed light on specific services most affected by downgrades, such as Fillings, Crowns, Inlays, Onlays, Dentures, Partials, Implants, Abutments, Bridgework, and Pontic.
Cigna Dental Downgrades:
Below is a table illustrating key downgrades under Cigna guidelines for various dental procedures:
| Expensive Procedure | CDT Code | Alternate Benefit | Downgrade Code |
|---|---|---|---|
| Resin-based composite - 1 surface posterior | D2391 | Amalgam - 1 surface | D2140 |
| Resin-based composite - 2 surface posterior | D2392 | Amalgam - 2 surface | D2150 |
| Resin-based composite - 3 surface posterior | D2393 | Amalgam - 3 surface | D2160 |
| Resin-based composite - 4 or more surface posterior | D2394 | Amalgam - 4 or more surface | D2161 |
| Crown - Porcelain/Ceramic substrate | D2740 | Crown - Full cast predominantly base metal | D2791 |
| Crown - Porcelain fused to high noble metal | D2750 | Crown full cast high noble metal | D2790 |
| Crown - Porcelain fused to predominantly base metal | D2751 | Crown - Full cast predominantly base metal | D2791 |
By understanding the nuances of downgrades, dental offices can better address patient inquiries and concerns regarding insurance coverage. This knowledge empowers both dental professionals and patients to make informed decisions about their oral healthcare, ensuring transparency and clarity in navigating the complexities of dental insurance. Stay informed, stay empowered, and join us as we unravel the mysteries of dental insurance downgrades.