Can D0365 be used for both diagnostic and treatment planning purposes?

Yes, D0365 is applicable for both diagnosing conditions and planning treatments such as implants.

Is prior authorization required for D0365?

This depends on the patient's insurance policy. It's advisable to check with the insurer beforehand.

How often can D0365 be billed for the same patient?

Frequency limits vary by insurance provider, so it's important to verify with them directly.

Does D0365 cover the interpretation of the scan?

Yes, D0365 includes both the capture and interpretation of the cone beam CT images.

D0365

Cone Beam CT Capture - CDT Code Guide

Diagnostic/Image Capture with Interpretation

Overview

CDT Code D0365 pertains to the cone beam computed tomography (CBCT) capture and interpretation specifically for a full dental arch of the mandible. This diagnostic procedure is crucial for obtaining detailed 3D images of the lower jaw, which aids in precise treatment planning for various dental procedures. The CBCT scan provides comprehensive views that are essential for assessing bone structure, tooth orientation, and any pathological conditions. Typically, this code is utilized in scenarios involving complex dental implant planning, evaluation of impacted teeth, or assessment of mandibular fractures. By capturing a full arch, dental professionals can ensure a thorough examination and accurate diagnosis, which is critical for effective treatment outcomes.

When to Use This Code

Planning for dental implants in the mandibular arch
Evaluating impacted mandibular teeth
Assessing mandibular fractures or trauma
Diagnosing pathologies within the mandibular arch
Pre-surgical evaluation for orthognathic surgery

Documentation Requirements

Detailed patient history and clinical indications for the CBCT scan
Written interpretation of the CBCT images by a qualified professional
Documentation of the specific area scanned (full dental arch mandible)
Patient consent for the imaging procedure
Record of the date and time of the procedure

Billing Considerations

When billing for D0365, it's important to note any frequency limitations imposed by insurance providers, as repeated imaging may not be covered. Common modifiers may include those indicating a bilateral procedure or additional areas scanned. Ensure that the necessity for the scan is clearly documented to avoid claim denials. Coordination with insurance providers to confirm coverage for CBCT scans is recommended.

Related CDT Codes

D0364 D0366 D0367 D0330 D0350

Frequently Asked Questions

D0365 is used for a full dental arch of the mandible, while D0364 is for a limited field of view.

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