What ADA CDT Dental Code is D0364?
The D0364 dental code is used for a cone beam computed tomography (CBCT) scan with a limited field of view, capturing less than one whole jaw. This code applies when a focused CBCT scan is needed to evaluate a specific area of the mouth, such as a single quadrant, to aid in diagnosis and treatment planning.
What Procedure Does D0364 Refer To?
D0364 involves capturing a limited cone beam CT scan and interpreting the results to assess a particular area of the jaw. This imaging provides high-resolution, 3D views that allow the dentist to evaluate bone structure, tooth positioning, and surrounding tissues in detail. The limited scope of this scan minimizes radiation exposure, making it ideal for targeted assessments.
Documentation Requirements and Best Practices for D0364
- Specify Field of View and Area Scanned: Document the exact area scanned, such as a quadrant or specific teeth.
- Include Diagnostic Purpose: Note the reason for the scan, such as evaluating for implant placement, identifying pathologies, or assessing bone density.
- Interpretation Findings: Document findings from the scan, including any observed abnormalities or relevant anatomical details.
- Record Additional Diagnostic Needs: If further imaging or evaluation is recommended, include it in the report.
How Can I Verify Patient Eligibility and Coverage for D0364?
To verify eligibility and coverage for D0364, contact the patient’s insurance provider. Some insurance plans cover CBCT scans with a limited field of view when medically necessary, though frequency limitations and prior authorization requirements may apply. Confirming eligibility helps inform the patient of any potential out-of-pocket costs.
How Should D0364 Be Submitted on an Insurance Claim, and Should a Site Be Included?
Submit D0364 with details on the specific area being scanned and the diagnostic reason. Including information such as the targeted quadrant or anatomical structure helps clarify the purpose of the limited field-of-view scan for claim processing.
D0364 Dental Code Cost
The cost of D0364 typically ranges from $150 to $350 without insurance, depending on provider, location, and the complexity of the scan. Patients should consult their dental office for a precise cost estimate based on their insurance plan.
ADA D0364 Guidelines
The ADA recommends D0364 for cases where detailed 3D imaging of a limited area is needed, supporting targeted diagnostics while minimizing radiation exposure. This scan type is ideal for specific diagnostic purposes, such as pre-implant assessment or endodontic evaluation, where only a focused view is required.
What is the Difference Between D0364 and Other Similar Codes?
| Code | Description | Purpose |
|---|---|---|
| D0364 | Cone beam CT capture and interpretation with limited field of view – less than one whole jaw | Focused 3D scan of a specific area |
| D0365 | Cone beam CT capture and interpretation with field of view of one full dental arch – mandible | Full 3D view of the mandibular arch |
| D0366 | Cone beam CT capture and interpretation with field of view of one full dental arch – maxilla | Full 3D view of the maxillary arch |
| D0367 | Cone beam CT capture and interpretation with both jaws | Full 3D view of both arches |
Why Was D0364 Specifically Used for My Treatment, and Are There Alternative Treatments with Different Codes and Costs?
D0364 is chosen for situations where a focused 3D view of a specific area is required, such as a quadrant or a few teeth. Alternatives include D0365 or D0366 for full-arch scans of either the mandible or maxilla, and D0367 for a complete scan of both arches. The choice depends on the area requiring assessment and the detail needed for treatment planning.
How Often Can You Bill D0364?
D0364 can be billed as needed for diagnostic purposes when evaluating a limited area. Insurance providers may impose restrictions on the frequency of CBCT scans, so verifying these guidelines with the patient’s specific insurance policy is recommended.
