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D23922 surfaces, posteriorDowngrade risk: amalgam rateName both surfaces

Posterior composite, two surfaces note template

A complete, fill-in-the-blank D2392 note written around what insurance reviewers ask for — with the documentation checklist, the denial patterns, and an Open Dental auto-note format built in.

01 · Before you bill it

Know what the payer wants first.

The note should answer every item on the left — and read so that nothing on the right applies.

What documentation D2392 requires

Missing any of these is why the claim pends for records.
  • Tooth number and both surfaces named, matching the code
  • Caries diagnosis with clinical AND radiographic (or photographic) confirmation
  • Isolation and bonding steps — evidence of definitive technique
  • Occlusal adjustment and contact verification noted

Why D2392 gets denied

The denial patterns payers actually use for this code.
  • Surfaces on the claim don\u2019t match surfaces in the note or on the film
  • Downgraded to amalgam rate — plan limitation, not a documentation failure; an intact narrative still supports appeal of outright denials
  • Replacement of an existing restoration inside the plan\u2019s replacement window without a documented failure reason

02 · The template

Copy it, chart with it.

Square brackets are the blanks — replace each one as you chart. Switch the format to turn every blank into an Open Dental auto-note prompt.

D2392 · Format
MEDICAL HISTORY: Reviewed [date]; changes: [none]. 
CHIEF COMPLAINT: [Patient's words / asymptomatic lesion found at exam].
DIAGNOSIS: Caries [tooth #] [surfaces], confirmed [clinically and on radiograph dated ___]; lesion into dentin; tooth restorable.
ANESTHETIC: [Agent, concentration] [__] mL via [IANB/infiltration]; profound.
ISOLATION: [Rubber dam / isolation system].
PROCEDURE: Caries excavated to [firm dentin]; [caries indicator used / visual-tactile verification]. [Liner/base if used]. [Selective/total] etch; [adhesive]; composite [shade] placed incrementally and cured; contacts verified with floss; occlusion adjusted; polished.
POST-OP: [Sensitivity guidance]; call if bite feels high after [interval].
NEXT VISIT: [Recall / remaining restorative].

03 · Common questions

Frequently asked about D2392

What if I replace an existing filling?
Document why: recurrent decay, fracture, open margin. Most plans have a 24-month replacement clause; the reason for replacement is what gets paid.
Does a bitewing need to show the lesion?
For interproximal lesions, yes — attach the film. Occlusal caries may need an intraoral photo instead.

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Or never fill in a blank again.

Molaris listens to the visit and drafts this exact note in your wording — placeholders already filled from what was actually said. You review, you sign, it files to Open Dental.

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Reviewed August 2026. These templates are original Molaris reference samples showing how the scribe structures documentation. They are educational examples, not billing, coding, or legal advice; payer requirements vary by plan and state. CDT codes are maintained by the ADA.