Understanding Dental Code D0320

When to Use D0320 dental code

The D0320 dental code is designated for a temporomandibular joint (TMJ) arthrogram, including the injection. This code should be used when a dentist or oral surgeon performs an arthrogram to evaluate the TMJ, typically to diagnose disorders such as internal derangement, disc displacement, or joint dysfunction. The procedure involves injecting contrast material into the TMJ and taking radiographic images to assess the joint’s anatomy and function. Use D0320 only when the full arthrogram procedure, including the injection, is performed and documented.

Documentation and Clinical Scenarios

Accurate documentation is critical for proper reimbursement and compliance. When billing for D0320, ensure the clinical notes include:

• Detailed patient history indicating TMJ symptoms (e.g., pain, clicking, limited movement)
• Clinical findings supporting the need for advanced imaging
• Procedure description outlining the injection of contrast and radiographic technique
• Radiographic findings and interpretation by the provider

Common scenarios for D0320 include patients with chronic TMJ pain unresponsive to conservative treatment, suspected disc displacement, or pre-surgical planning for TMJ interventions. Always confirm that the procedure performed matches the code description to avoid claim denials.

Insurance Billing Tips

Billing D0320 successfully requires attention to payer policies and best practices in dental insurance workflows:

• Verify coverage before the procedure, as not all dental plans cover TMJ diagnostics. Obtain preauthorization if required.
• Submit clear, thorough documentation with the claim, including clinical notes and radiographic reports.
• Use correct CDT code sequencing if D0320 is performed alongside other diagnostic procedures (e.g., panoramic radiographs). Reference related codes with proper documentation.
• If denied, appeal the claim by submitting additional clinical justification and referencing medical necessity.
• Monitor accounts receivable (AR) for timely follow-up on outstanding claims.

Successful dental offices establish a workflow for insurance verification, preauthorization, and claim appeals to minimize delays and maximize reimbursement for complex procedures like TMJ arthrograms.

Example Case for D0320

Case: A 34-year-old patient presents with chronic right-sided jaw pain, limited opening, and audible clicking. Conservative therapies (splints, NSAIDs) have failed. The dentist suspects internal derangement of the TMJ and recommends an arthrogram to assess disc position and joint anatomy.

Workflow:

• Front desk verifies insurance coverage for D0320 and obtains preauthorization.
• Provider documents detailed history, clinical findings, and rationale for advanced imaging.
• Procedure is performed: contrast is injected, radiographs are taken, and findings are interpreted.
• Billing team submits claim with D0320, attaching clinical notes and radiographic report.
• If the claim is denied, the office promptly appeals with additional documentation of medical necessity.

This step-by-step approach ensures compliance, supports medical necessity, and improves the likelihood of reimbursement for TMJ arthrograms billed under D0320.