The American Dental Association recently contacted dental insurance company Principal to get clarity on a new policy regarding periapical radiographs.
Five notes:
1. Principal recently notified dentists that it would begin requesting additional documentation for periapical radiographs taken during routine hygiene visits.
2. Members from the ADA’s Council on Dental Benefit Programs met with representatives from Principal Feb. 20 to discuss the new policy after the notification caused confusion among providers, according to a Feb. 20 news release.
3. The ADA clarified that Principal will only be reviewing claims that include two or more periapical radiographs reported with code D0120 periodic oral evaluation and code D1110 adult prophylaxis.
4. Additionally, Principal will be requiring copies of the radiographs in addition to narratives based on patient-specific needs rather than routine practice.
5. The ADA also noted that if a clinical need for periapical radiographs is not documented, the insurer will request this information to make a benefit determination.
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