Tips for Writing Narratives

1. What did the doctor observe that made her decide that the patient needed a crown, onlay, buildup, etc.?

2. Is that information obvious on the radiograph? If not, include a narrative stating the details that are not evident on the radiograph, for example:

• ML cusp fx off at gum line.
• MOD amalgam obscures gross lingual decay.
• 30 M decay & recurrent decay around existing occ. amal. Also, Class V wrap-around decay evident on B, L, M & D – not visible on radiograph.

3. Sample Buildup Narratives:

• #19 large MOD amal., ML & DL cusps fx off at gum line.
• #30 large MOD amal., extensive caries, transillumination shows fracture lines into dentin at gingival margin across MF and DF cusps.
• Existing circumferential caries at gingival margin and extensive caries detectable by explorer under existing crown.

4. Crown Narratives – what payers are looking for:

• Must have pathologic destruction to a permanent tooth by caries or trauma and must involve three or more surfaces and at least one cusp (or at least 50 percent of the incisal edge, ofanterior tooth).