D2542 — Metallic onlay — two surfaces
An onlay is a lab-made or milled restoration that covers one or more cusps of a back tooth. D2542 is the two-surface version in cast metal, with no ceramic layer.
One of nine onlay codes. If you are trying to understand the treatment, start with the onlay guide; if you are trying to understand this line on your estimate, you are in the right place.
Everything below is specific to this code: what it pins down, what it is worth, how a payer handles it, and which codes it is not.
D2542 in detail
Extent — two surfaces. Two surfaces means the restoration turns a corner and has to rebuild the contact against the neighbouring tooth. Recreating that contact — tight enough to hold floss, loose enough to let it pass — is what makes it harder than a one-surface repair, not the extra material.
Material — cast metal, with no ceramic layer. A one-piece metal casting with nothing fired over it. Metal can be made far thinner than ceramic at the same strength, so less of the tooth has to be reduced, and the margins can be finished more closely than with any other material. It is obviously metallic, which limits it to positions where that does not matter. The material is part of the code rather than a choice made afterwards, so D2542 is only the right code if that is what was actually used.
Where the line falls between D2542 and the rest
D2543 — Metallic onlay — three surfaces: It covers three surfaces instead of two surfaces.
D2544 — Metallic onlay — four or more surfaces: It covers four or more surfaces instead of two surfaces.
D2642 — Porcelain onlay — two surfaces: It specifies porcelain rather than cast metal, with no ceramic layer.
D2643 — Porcelain onlay — three surfaces: It covers three surfaces instead of two surfaces.
D2542 sits in a group of nine codes in total; the remainder are linked at the foot of this page. A plan reads these codes as definitions, not as descriptions. If the notes for the visit do not match D2542 exactly, the claim is assessed as whichever of these the notes do match.
Every code in this group
These codes describe the same broad procedure and differ in one respect each. Each has its own page with its own fee range and coverage notes.
Questions about D2542
What is D2542 on my dental bill?
It is the entry for metallic onlay, two surfaces. A practice cannot use it for anything broader than that, which is what makes the code useful to you.
What is the typical fee for D2542?
Expect $1,075–$2,275. Ask for the number in writing, because the code carries no fee of its own and every practice sets its own.
Will my plan pay for D2542?
Plans generally pay it as major treatment, typically 50%, subject to whatever is left of your maximum for the year.
What is the difference between D2542 and D2543?
D2543 is metallic onlay, three surfaces: it covers three surfaces instead of two surfaces. Nothing else separates them, which is exactly why a claim submitted under the wrong one of the two is such a common correction.
Also known as: onlay, partial crown, cusp coverage, indirect restoration, cracked tooth restoration.