Hi Guest!

D0383 - Cone beam CT image capture with field of view of both jaws, with or without cranium

There is actually not currently a specific CPT code for CBCT……the closest CPT code is: 70486 - Computed tomography, maxillofacial area; without contrast material. Many offices have been using this for some time for CBCT, however, some medical insurers are auditing that code when used for CBCT because the description does not specify “cone beam”.

So, “76497 - Unlisted computed tomography procedure (eg, diagnostic, interventional)” is a good CPT code to use, or, many medical insurers will process the “D” codes for procedures when there is not a specific CPT code available.

For example, here are the “D” codes from HealthPartner’s medical policy for “Cone-beam computed tomography (CT) scan for medically-related dental services”

D0363 - Cone-Beam 3D multi image reconstruction
D0364 - Cone beam CT capture and interpretation with limited field of view - less than one whole jaw
D0365 - Cone beam CT capture and interpretation with field of view of one full dental arc - mandible
D0366 - Cone beam CT capture and interpretation with field of view of one full dental arch
- maxilla, with or without cranium
D0367 - Cone beam CT capture with interpretation with field of view of both jaws, with or without cranium
D0368 - Cone beam CT capture and interpretation for TMJ series including two or more exposures
D0380 - Cone beam CT image capture with limited field of view - less than one whole jaw
D0381 - Cone beam CT image capture with field of view of one full dental arch - mandible
D0382 - Cone beam CT image capture with field of view of one full dental arch - maxilla, with or without cranium
D0383 - Cone beam CT image capture with field of view of both jaws, with or without cranium
D0384 - Cone beam CT image capture for TMJ series including two or more exposures

Here is a link to the full policy:
https://www.healthpartners.com/public/coverage-criteria/cone-beam-scan.htm


As for the diagnosis code - you are correct "implant 13" is not going to do the trick!
I can offer you some coding options but I encourage you to verify the choices with your dentist. In order to select the appropriate code(s) - I will need a little bit more information:

What is the reason the implant is being considered? (i.e. lost teeth due to trauma, lost teeth due to periodontal disease, pain, lesions, atrophy, etc)

Hi Guest!

Ok great - here are some diagnosis coding options for you:

For the loss of teeth due to periodontal disease:
K08.421 - Partial loss of teeth due to periodontal diseases, class I
K08.422 - Partial loss of teeth due to periodontal diseases, class II
K08.423 - Partial loss of teeth due to periodontal diseases, class III
K08.424 - Partial loss of teeth due to periodontal diseases, class IV
K08.429 - Partial loss of teeth due to periodontal diseases, unspecified class

For the atrophy:
K08.21 - Minimal atrophy of the mandible
K08.22 - Moderate atrophy of the mandible
K08.23 - Severe atrophy of the mandible
K08.24 - Minimal atrophy of maxilla
K08.25 - Moderate atrophy of the maxilla
K08.26 - Severe atrophy of the maxilla

Hope this helps!