D0330 - Panoramic X-Ray
Panoramic image.
- Procedure Code
- D0330
- Category
- Diagnostic
Insurance Verification Benchmarks & Billing Guidelines
Benchmark Policy Source: Delta Dental National / PPO Standard
- Frequency Limitation
- 1 every 36 to 60 months (shared frequency with D0210 FMX) (ROLLING_MONTHS)
- Age Limitation
- Covered typically age 6 and older for mixed dentition and third molar evaluation.
Required Claim Attachments & Pre-Submission Checklist
- Diagnostic panoramic image showing entire maxilla, mandible, and TMJ regions
- Clinical rationale documented (e.g. impactions, orthodontic planning, bone pathology)
Bill When (Allowable Clinical Criteria)
- Evaluation of third molars, orthodontic assessment, oral surgery, or pathology
Restrictions & Clinical Exclusions
- Do NOT bill on same day as Full Mouth Series D0210
Common Claim Denial Codes & Overturn Strategies
| Denial Code | Denial Reason | Appeal & Overturn Strategy |
|---|---|---|
| CO-119 | Exceeds frequency or FMX D0210 was reimbursed within last 3-5 years | Check patient history for previous carrier FMX date. |
ICD-10 Justification & Crosswalk Mappings
| ICD-10 Code | Diagnosis Name | Category | Primary Justification | Claim Type | Clinical Scenario |
|---|---|---|---|---|---|
| Z01.20 | Encounter for dental examination and cleaning without abnormal findings | Encounter for other special examination without diagnosis | Yes (Primary) | BOTH | panoramic radiographic image indicated for Encounter for dental examination and cleaning without abnormal findings |
| Z01.21 | Encounter for dental examination and cleaning with abnormal findings | Encounter for other special examination without diagnosis | Secondary | BOTH | panoramic radiographic image indicated for Encounter for dental examination and cleaning with abnormal findings |
| Z13.84 | Encounter screening for dental disorders | Encounter for screening for other diseases and disorders | Secondary | BOTH | panoramic radiographic image indicated for Encounter screening for dental disorders |
| Z86.16 | Personal History of COVID-19 | Personal history of certain other diseases | Secondary | BOTH | panoramic radiographic image indicated for Personal History of COVID-19 |
| U07.1 | COVID-19 | Emergency use of U07 | Secondary | BOTH | panoramic radiographic image indicated for COVID-19 |