What ADA CDT Dental Code is D0367?
The D0367 dental code represents a cone beam computed tomography (CBCT) scan that captures and interprets the full field of view of both jaws, with or without the inclusion of the cranium. This comprehensive scan provides detailed 3D images of the entire maxillofacial region, aiding in diagnostics and treatment planning for complex cases.
What Procedure Does D0367 Refer To?
D0367 involves capturing a CBCT scan that includes both the maxillary and mandibular arches and can include portions of the cranium if necessary. This scan allows the dentist or radiologist to evaluate the bones, teeth, and supporting structures in 3D, providing a complete view of the oral and maxillofacial region, which is essential for advanced diagnostics and treatment planning.
Documentation Requirements and Best Practices for D0367
- Specify Field of View and Areas Captured: Document the extent of the field of view, indicating whether the cranium was included.
- Describe Diagnostic Purpose: Note the reason for the scan, such as implant planning, evaluating jaw relationships, or assessing pathology.
- Record Interpretation Findings: Document key findings from the scan, including any abnormalities, structural concerns, or observations related to treatment planning.
- Include Additional Recommendations: If further imaging or consultation is advised, record these recommendations in the report.
How Can I Verify Patient Eligibility and Coverage for D0367?
To verify eligibility and coverage for D0367, contact the patient’s insurance provider. Full-field CBCT scans are typically covered when deemed medically necessary, but frequency limits or prior authorization requirements may apply. Verifying eligibility helps the patient understand any potential out-of-pocket expenses.
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How Should D0367 Be Submitted on an Insurance Claim, and Should a Site Be Included?
Submit D0367 with details about the diagnostic purpose of the scan and specify if the cranium was included. Including this information helps clarify the scope and need for a full-field scan, supporting accurate claim processing.
D0367 Dental Code Cost
The cost of D0367 typically ranges from $300 to $700 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 D0367 Guidelines
The ADA recommends D0367 for cases requiring a comprehensive 3D view of both jaws and, if needed, the cranium. This full-field CBCT scan is particularly useful for advanced treatment planning, such as in cases of complex orthodontics, maxillofacial surgery, implant placement, or TMJ assessment.
What is the Difference Between D0367 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 field of view of both jaws; with or without cranium | Full 3D view of both arches, possibly including cranium |
Why Was D0367 Specifically Used for My Treatment, and Are There Alternative Treatments with Different Codes and Costs?
D0367 is chosen when a comprehensive 3D view of both jaws, and possibly the cranium, is needed for complex diagnostic and treatment planning purposes. Alternatives include D0365 or D0366 if only one arch requires a full view, or D0364 for a limited view focusing on a smaller area. The choice depends on the area that requires assessment and the detail needed for diagnosis and treatment.
How Often Can You Bill D0367?
D0367 can be billed as needed for complex diagnostic evaluations. However, frequency restrictions may apply based on the patient’s insurance policy, so it is recommended to verify specific billing guidelines with the patient’s insurance provider.
