NARRATIVE CROWN, ONLAY, INLAYS
To whom it may concern:
1. First and foremost—you must state that the CROWN is required for Tooth # with a x-ray or better yet, with a photo (IOC).
2. Describe any and all damage to the natural tooth (Some carriers only pay for buildups if more than 50% of the natural tooth structure is missing.)
-Identify the size and condition of prior restorations
-Indicate areas of new or recurrent decay
-State the compromised circumferential structure (e.g., buccal and lingual walls missing, less than 2mm circumferential tooth height, etc.)
3. Indicate adequate bone support. (Some carriers specifically state that there must be a mid-root bone level with no furcation involvement.)
Insurance narratives need to be brief, but specific. A good crown narrative might look like this:
#30 prior endo and MODB with new ML and DL decay, DB cusp fx. off, H & C sens., less than 1/3 natural tooth remaining, crown was needed to support the tooth structure. Adequate bone support—AAP Type 1. X-ray and/or photo included.
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