Question

We are fairly new to billing cone beam images to insurance companies. So far, all our claims have been denied. Are you aware of any dental plans that cover the cone beam CT codes?

While most dental carriers have been slow to cover cone beam CTs, several now do in certain situations, and we have heard that others are in the process of developing coverage guidelines.

Even when listed as a benefit, coverage depends on the clinical necessity. Situations where cone beam CT may be covered include but are not limited to:

  • Impacted third molars positioned close to the inferior alveolar nerve,
  • Proposed implant placement close to the inferior alveolar nerve or sinus,
  • Proposed implant placement where there may be inadequate bone, or
  • TMJ abnormalities/pathology.
  • Oral surgery near critical structures.

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