Understanding Dental Code D0322

When to Use D0322 dental code

The D0322 dental code is designated for a tomographic survey of the jaws, a specialized imaging procedure that provides cross-sectional views of dental structures. This code is most appropriately used when a dental provider requires detailed imaging beyond standard intraoral or panoramic radiographs, such as for evaluating impacted teeth, jaw pathology, implant planning, or TMJ disorders. It is important to use D0322 only when the clinical situation truly warrants this advanced diagnostic tool, as improper use can lead to claim denials or compliance issues.

Documentation and Clinical Scenarios

Accurate documentation is critical when billing for D0322. The patient’s chart should clearly indicate the medical necessity for a tomographic survey, including:

• Specific symptoms or findings (e.g., suspected cysts, tumors, or bone abnormalities)
• Previous imaging results and why further imaging is needed
• Detailed clinical notes describing the rationale for choosing tomographic imaging over other modalities

Common clinical scenarios for D0322 include pre-implant assessment, evaluation of jaw lesions, or complex orthodontic cases where 3D visualization is essential. Always ensure that the documentation supports the use of this code and aligns with the payer’s medical necessity requirements.

Insurance Billing Tips

To maximize reimbursement and minimize delays, follow these best practices when billing D0322:

• Verify coverage: Not all dental plans cover tomographic surveys. Check benefits and obtain pre-authorization if required.
• Submit clear documentation: Attach clinical notes, radiology reports, and any supporting images to the claim.
• Use correct coding: Do not substitute D0322 for other radiographic codes such as D0330 panoramic radiograph or D0367 CBCT scan. Use D0322 only for true tomographic surveys.
• Appeal denied claims: If a claim is denied, review the EOB for the reason, supplement with additional documentation, and submit a timely appeal outlining medical necessity.

Staying proactive with insurance verification and thorough documentation will help your practice avoid common billing pitfalls associated with advanced imaging codes.

Example Case for D0322

Consider a patient presenting with persistent jaw pain and swelling. Initial panoramic and intraoral radiographs are inconclusive. The dentist suspects a cystic lesion in the mandible and orders a tomographic survey for precise localization and assessment. The clinical notes detail the patient’s symptoms, previous imaging, and the need for advanced imaging. The claim is submitted with D0322, accompanied by supporting documentation and images. Insurance approves the claim, recognizing the medical necessity. This scenario highlights the importance of proper code selection, documentation, and communication with payers when using D0322.