When to send x-rays
Determining the type of documentation to send with your claim
Approximately one-third of the claims Delta Dental receives with x-rays do not require x-rays for Delta Dental to make its claim evaluation. Unnecessary submission of x-rays can be costly and time-consuming for the dental office, and may actually delay processing of your claim.
Usually, Delta Dental requires x-ray documentation (or in some cases periodontal charting) only for the procedures listed below. On occasion, a dental consultant may deem it necessary, given the circumstances of a particular case, to request x-rays for procedures that are not on this list. X-ray documentation is requested only when absolutely necessary for determining benefits. If you don't need to have your x-ray copies returned, place "do not return" stickers on the x-ray mount.
Order free stickers by writing to: Delta Dental - MS WO1, P.O. Box 997330, Sacramento, CA 95899-7330.
Procedure codes that require x-ray submission
Restorative
| D2390 |
Resin-based composite crown, anterior |
| D2510 - 2644 |
Inlay/onlay restorations |
| D2710 - 2794 |
Crowns - single restorations only |
| D2950 |
Core buildup, including any pins |
| D2960 - 2962 |
Labial veneers |
Implant Services
| D3460 |
Endodontic endoseous implant |
| D6010 - D6199 |
Implant procedures |
Periodontics
| D4249 |
Clinical crown lengthening - hard tissue |
Prosthodontics, fixed
| D6545 - D6634 |
Fixed partial denture retainers - inlays/onlays |
| D6710 - D6794 |
Fixed partial denture retainers - crowns |
| D6973 |
Core build-up for retainer, including any pins |
Oral surgery
| D7111 |
Coronal remnants - deciduous tooth |
| D7241 - 7250 |
Surgical extractions (includes local anesthesia, suturing, if needed and routine post-operative care) |
| D7261 - D7272 |
Other surgical procedures |
| D7540 |
Removal of reaction-producing foreign bodies, musculoskeletal system |
| D7560 |
Maxillary sinusotomy for removal of tooth fragment or foreign body |
| D7940 - D7949 |
Osteoplasty/osteotomy/LeFort I, II and III |
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