D0701ADA CDT ProcedureDiagnosticTESTS AND EXAMINATIONS

D0701 - Panoramic Capture

Panoramic radiographic image – image capture only.

Patient-Friendly Summary: The technical image capture of a panoramic X-ray taken without interpretation by the capturing staff. It produces a wide single image of your jaws, teeth, and sinuses for diagnostic review. You stand still comfortably while the scanner circles around your head.
Clinical Documentation Notes: Not a covered benefit.
Procedure Code
D0701
Clinical Category
Diagnostic
Reference Fee & Claim Types
BOTH

Insurance Verification Benchmarks & Billing Guidelines

Payer policy benchmarks, pre-submission attachment requirements, and denial prevention rules for D0701.

Source: Delta Dental 2026
Frequency Limitation
Subject to group/individual contract frequency limitations (none)

Required Claim Attachments & Pre-Submission Checklist

  • Standard ADA claim form with CDT procedure code and date of service

Bill When (Allowable Clinical Criteria)

  • Indicated for medically and clinically necessary treatment as documented in patient's dental record.

Common Claim Denial Codes & Overturn Strategies

Denial CodeDenial ReasonAppeal & Overturn Strategy
CO-119Benefit maximum or frequency limitation exceeded for procedureSubmit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria.

ICD-10-CM Justification & Crosswalk Mappings for D0701 (5)

Click any ICD-10-CM diagnosis code below to inspect its reverse procedure mappings and differential coding guide.

ICD-10 CodeDiagnosis NameCategoryPrimary JustificationClaim TypeClinical Scenario
Z01.20Encounter for dental examination and cleaning without abnormal findingsEncounter for other special examination without diagnosis★ Yes (Primary)BOTHpanoramic radiographic image – image capture only indicated for Encounter for dental examination and cleaning without abnormal findings
Z01.21Encounter for dental examination and cleaning with abnormal findingsEncounter for other special examination without diagnosisSecondaryBOTHpanoramic radiographic image – image capture only indicated for Encounter for dental examination and cleaning with abnormal findings
Z13.84Encounter screening for dental disordersEncounter for screening for other diseases and disordersSecondaryBOTHpanoramic radiographic image – image capture only indicated for Encounter screening for dental disorders
Z86.16Personal History of COVID-19Personal history of certain other diseasesSecondaryBOTHpanoramic radiographic image – image capture only indicated for Personal History of COVID-19
U07.1COVID-19Emergency use of U07SecondaryBOTHpanoramic radiographic image – image capture only indicated for COVID-19

Frequently Asked Questions — D0701 (Panoramic Capture)

Quick answers for dental billers and treatment coordinators submitting claims for D0701.

What ICD-10 diagnosis codes link to dental procedure D0701?▾

Common ICD-10-CM justification codes for CDT D0701 (Panoramic Capture) include: Z01.20 - Encounter for dental examination and cleaning without abnormal findings (Primary); Z01.21 - Encounter for dental examination and cleaning with abnormal findings; Z13.84 - Encounter screening for dental disorders; Z86.16 - Personal History of COVID-19; U07.1 - COVID-19.

Can CDT code D0701 be billed to medical insurance?▾

Billing CDT D0701 (Panoramic Capture) to medical insurance depends on the underlying clinical necessity and trauma/pathology documentation. Supported claim types across linked diagnoses: BOTH.

What attachments and documentation are required for billing CDT D0701?▾

Required claim attachments for CDT D0701 (Panoramic Capture) include: Standard ADA claim form with CDT procedure code and date of service.

What is the insurance frequency limitation for CDT D0701?▾

Standard commercial insurance frequency for D0701: Subject to group/individual contract frequency limitations (none).

What are common insurance denial reasons and appeal tips for CDT D0701?▾

Denial Code CO-119 (Benefit maximum or frequency limitation exceeded for procedure): Overturn appeal strategy - Submit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria.