Billing Guide for D0350 - 2D Oral/Facial Photographic Image Obtained Intra-Orally or Extra-Orally
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Description
Billing Guidelines, Tips and Reminders for D0350 (2D Oral/Facial Photographic Image Obtained Intra-Orally or Extra-Orally)
February 02, 2025
MATCH
Each component of orthodontic records is reported separately. There are no global or specific code(s) to report orthodontic records. 2D oral/facial photographic images (D0350) are considered to be a component of orthodontic records. See also cephalometric radiographic images (D0340) and diagnostic casts (D0470), which are common components of orthodontic records.
COMMENTS
1. 2D Intraoral or facial images are essential parts of documentation and are crucial for maximizing reimbursement from insurers.
2. There are no global or specific code(s) for orthodontic records.
3. D0350 includes both traditional photographs and images obtained by intra-oral or extra-oral cameras. These 2D images are a part of the patient's clinical record. D0350 describes 2D oral and/or facial photographic images.
4. For 3D scans, see D0801, D0802, D0803, and D0804.
5. For 2-D oral/facial photographic image obtained intra-orally - image capture only, see D0703.
LIMITATIONS
1. 2D oral/facial photographic images (D0350) are not typically reimbursed except as a component of orthodontic records.
2. The claim form question, "Is this for orthodontics?" must be answered "yes" (Box 40 of the 2024 ADA Dental Claim Form) for D0350 to be considered a part of the orthodontic records. D0350 is considered to be a part of orthodontic records/workup and is typically reimbursed once per lifetime. See cephalometric radiographic image (D0340) and diagnostic casts (D0470) for further orthodontic record component details.
3. Reimbursement for 2D oral/facial photographic images (D0350) may reduce the lifetime orthodontic benefit. If orthodontic benefits are available these photographic images are typically reimbursed at 50% of the payor's fee. Sometimes the general dental benefit component of the plan will reimburse for photographic images separate from the orthodontic benefit. If reimbursed as part of the general dental benefits, D0350 may be paid at 50%, 80%, or 100% of the payor's fee.
TIPS
1. While payors do not generally reimburse 2D oral photographic images (D0350), (except when part of orthodontic records) practices can add "value" by charging a "zero" fee and listing it on the walkout statement.
2. Intra-oral photographs often provide documentation that is helpful in proving medical necessity. In particular, photographs can be helpful in documenting the need for soft and connective tissue grafts, crowns and onlays, core buildups, labial veneers, frenectomies, and apically repositioned flaps. If the problem is not obvious on a radiographic image but is seen on the photograph, by all means, send it. Intra oral images are essential.
NARRATIVES
Photos are helpful to document cusp fractures, missing and undermined cusps, and cracks for onlays and crowns. Use a dye to emphasize the crack. Photos can also illustrate pocket depths (with probe in place) for periodontal documentation. Example narrative: "The photograph demonstrates a fractured mesio-buccal cusp that is not visible on the diagnostic film. Crown/onlay coverage is necessary."
Each component of orthodontic records is reported separately. There are no global or specific code(s) to report orthodontic records. 2D oral/facial photographic images (D0350) are considered to be a component of orthodontic records. See also cephalometric radiographic images (D0340) and diagnostic casts (D0470), which are common components of orthodontic records.
COMMENTS
1. 2D Intraoral or facial images are essential parts of documentation and are crucial for maximizing reimbursement from insurers.
2. There are no global or specific code(s) for orthodontic records.
3. D0350 includes both traditional photographs and images obtained by intra-oral or extra-oral cameras. These 2D images are a part of the patient's clinical record. D0350 describes 2D oral and/or facial photographic images.
4. For 3D scans, see D0801, D0802, D0803, and D0804.
5. For 2-D oral/facial photographic image obtained intra-orally - image capture only, see D0703.
LIMITATIONS
1. 2D oral/facial photographic images (D0350) are not typically reimbursed except as a component of orthodontic records.
2. The claim form question, "Is this for orthodontics?" must be answered "yes" (Box 40 of the 2024 ADA Dental Claim Form) for D0350 to be considered a part of the orthodontic records. D0350 is considered to be a part of orthodontic records/workup and is typically reimbursed once per lifetime. See cephalometric radiographic image (D0340) and diagnostic casts (D0470) for further orthodontic record component details.
3. Reimbursement for 2D oral/facial photographic images (D0350) may reduce the lifetime orthodontic benefit. If orthodontic benefits are available these photographic images are typically reimbursed at 50% of the payor's fee. Sometimes the general dental benefit component of the plan will reimburse for photographic images separate from the orthodontic benefit. If reimbursed as part of the general dental benefits, D0350 may be paid at 50%, 80%, or 100% of the payor's fee.
TIPS
1. While payors do not generally reimburse 2D oral photographic images (D0350), (except when part of orthodontic records) practices can add "value" by charging a "zero" fee and listing it on the walkout statement.
2. Intra-oral photographs often provide documentation that is helpful in proving medical necessity. In particular, photographs can be helpful in documenting the need for soft and connective tissue grafts, crowns and onlays, core buildups, labial veneers, frenectomies, and apically repositioned flaps. If the problem is not obvious on a radiographic image but is seen on the photograph, by all means, send it. Intra oral images are essential.
NARRATIVES
Photos are helpful to document cusp fractures, missing and undermined cusps, and cracks for onlays and crowns. Use a dye to emphasize the crack. Photos can also illustrate pocket depths (with probe in place) for periodontal documentation. Example narrative: "The photograph demonstrates a fractured mesio-buccal cusp that is not visible on the diagnostic film. Crown/onlay coverage is necessary."
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