X-Rays

Did you know that approximately one-third of the x-rays we receive with claims are not necessary? Save time and money by sending x-rays only when needed with claims for your Delta Dental Premier® and Delta Dental PPOSM patients.1 Below is a list of the only procedures for which we need an x-ray copy attached with the claim.

It is important not to submit original x-rays, especially if they are the only diagnostic record for your patient. Duplicate films and x-ray copies of diagnostic quality, including paper copies of digitized images, are acceptable.

We do not return x-rays and other supporting documentation; however, we will make an exception if you send us a stamped, self-addressed envelope along with the claim. We will use your envelope to return x-rays or other documentation to you after the benefit determination has been made.

Procedures That Require X-Ray Submission

Restorative:
D2710-D2794 Crowns - laboratory processed
D2950 Core buildup, including any pins
Implant services:
D6055-D6077 Implant supported prosthetics
Prosthodontics, fixed:
D6710-D6794 Fixed partial denture retainers - crowns
D6973 Core buildup for retainer, including any pins

Why We Need X-Rays

For some procedures, x-rays help us determine if treatment is covered under the patient's benefits plan. For example, a consultant reviews a preoperative x-ray when a claim is received for a cast restoration to see if the contractual criterion has been met for coverage: that so much tooth structure has been lost from caries or fracture that a direct amalgam or resin restoration would not be an adequate restoration.

Please call DeltaCare® USA Customer Service at 800-422-4234 for clarification when x-rays are needed.

  • 1 These x-ray guidelines apply to your Delta Dental Premier and Delta Dental PPO patients with coverage through or administered by Delta Dental Insurance Company (Alabama, Florida, Georgia, Louisiana, Mississippi, Montana, Nevada, Texas and Utah) and Delta Dental of California, Delta Dental of Delaware, Delta Dental of the District of Columbia, Delta Dental of New York, Delta Dental of Pennsylvania/ Maryland and Delta Dental of West Virginia.

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