Webd0321 other temporomandibular joint radiographic images nc: d0322 tomographic survey nc: d0330 panoramic radiographic image $42.10: d0340 2d cephalometric radiographic … WebD0351 3D photographic image D0704 3D photographic image – image capture only . The following procedure codes have revisions to their existing definitions. ... D0393 …
NJ FamilyCare A, ABP, B - Child - LIBERTY Dental Plan
WebOrthodontic Services. D0340 Cephalometric film – may be allowed if completed more than 3 months prior to the start of orthodontic treatment. D0350 Oral/facial images (including intra and extraoral images) – may be allowed if completed more than 3 months prior to the start of orthodontic treatment. D0351 3D photographic image – may be ... WebD0351 3D Photographic Image $82 D0364 Cone Beam CT Capture and Interpretation with $184 Limited Field of View – Less Than One Whole Jaw ... With or Without Cranium D0383 Cone Beam CT Image Capture with Field of View of $184 Both Jaws; With or Without Cranium D0417 Collection and Preparation of Saliva Sample for $75-$151 Laboratory … canada life group investor relations
Schedule of Covered Services and Copayments Family Dental …
Web2D Oral/facial photographic images obtained intraorally or extraorally. D0351. 3D photographic image. D0470. Diagnostic Casts. D0601. Caries risk assessment and documentation, with a finding of low risk. D0602. WebD0351 . 3D photographic image N/A Not covered/FSA covered Narrative if billed as part of Orthodontia records Not covered/ Orthodontia . ADA CODE Description Dental Review or Pre-D Documentation Required Class . 055369 (07-09-2024) An Independent Licensee of the Blue Cross Blue Shield Association . D0364 Cone beam CT capture and ... WebD0351: 3D photographic image: D0704: 3D photographic image – image capture only fisher admissions portal