Understanding D0364 Dental Code for CBCT Scans

What ADA CDT dental code is D0364?

D0364 is the ADA CDT dental code for a cone beam CT scan (CBCT) and interpretation for a limited area (less than one jaw). This is commonly used as the CBCT dental code. The code description is officially “cone beam CT capture and interpretation with limited field of view – less than one whole jaw.”

Frequently Asked Questions About D0364 Dental Code

What procedure does D0364 refer to?

This code covers the capture and interpretation of a cone beam CT image with a limited field of view, typically used for specific areas like a single tooth or small region.

What are the documentation requirements and best practices for D0364?

Documentation should include a detailed interpretation of the CBCT image, focusing on the specific area examined and noting any abnormalities or issues.

What are the typical costs, reimbursement rates and guidelines for D0364?

Costs typically range from $150 to $300, with reimbursement varying. It is often covered under diagnostic benefits for specific, targeted assessments.

Are there any common errors or pitfalls to avoid with D0364?

Common pitfalls include poor-quality images and inadequate documentation of findings, leading to incomplete diagnosis and potential claim denials.

How should D0364 be submitted on an insurance claim, and should a site be included?

Submit with the CBCT image and detailed interpretation. Specify the area examined. Site-specific details are critical for targeted diagnostics.

Is D0364 often used with other codes, and how does it fit into the overall coding system?

Often used with codes for specific diagnostic or treatment planning needs, such as implant placement or complex tooth extractions. It provides detailed information for precise procedures.

How can I verify patient eligibility and coverage for this procedure?

Verify eligibility by contacting the insurance provider to ensure coverage for CBCT images with a limited field of view.

What are the ethical considerations and common fraud indicators associated with D0364?

Maintain accurate and detailed records of the CBCT findings to avoid fraud. Ensure the imaging is necessary and clinically justified for the specific area examined.

What are the key differences between similar codes?

D0364 is for limited field CBCT images, while D0365 to D0367 cover different extents of CBCT imaging. Use D0364 for focused diagnostics on small regions.

Why was D0364 specifically used for my treatment, and are there alternative treatments with different codes and costs?

D0364 is used for detailed assessment of specific areas. Alternatives include D0365 for lower jaw only (mandible), D0366 for upper jaw only (maxilla), or D0367 for the entire mouth (upper and lower jaws together), depending on the diagnostic needs.

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