I've been practicing for awhile in an office without a panorex machine, and now I'm in an office with one. I am told that a pan and 4 bwxs on the same visit is not covered, however I remember it was never a problem in my first office. I am told insurance is different now. Is this true because to me it does not make sense! Thanks so much for any advice!
This is a common question and the answer is dependent upon the limitations particular to each plan; therefore, what may apply with one plan might very well be different with another one but I will answer this question as best I can based upon how it should be reported.
With most plans reimbursement for a panoramic film will be better when taken alone on a given date than when taken in conjunction with bitewing images; although decisions obviously should be based upon clinical indications for the patient irrespective of insurance benefits. When both panoramic and bitewing x-rays are taken on the same date; they should always be reported by the dental office separately and not as an intraoral complete series. Insurance companies routinely reimburse a panorex and bitewings performed on the same date as a complete series and therefore consider it equal to a complete series in terms of benefits; but diagnostically they are different. The contract language of most plans allow for “alternate benefit” reimbursements therefore, insurance companies have the latitude to make those adjustments.