D0340 is the CDT code for a 2D cephalometric X-ray, a standardized side or front view of the skull, including its tracing and analysis.
- When to use: The orthodontist or surgeon needs a standard 2D ceph for diagnosis, a records packet, or tracking skeletal change during treatment.
- When not to use: A pano is D0330, photos are D0350, casts are D0470, and a ceph view taken from a cone beam scan belongs in the cone beam codes.
- Billing note: Many plans fold the ceph into a records or case fee, so verify whether records pay separately, and do not add a separate tracing charge.
What D0340 covers
D0340 reports a 2D cephalometric radiographic image: a standardized lateral (side) or frontal view of the skull, captured with a cephalostat that holds the head in a fixed position with reproducible x-ray beam geometry. The standardization lets the clinician measure the relationship of the teeth, jaws, and skull, and compare images over time.
The code covers the image, the measurement, and the analysis together. A separate charge for tracing or cephalometric analysis on top of D0340 is not appropriate; it will be denied as bundled and can flag the account.
D0340 is used mostly in orthodontic and oral-surgery practices for diagnosis, treatment planning, and tracking skeletal change through treatment.
The orthodontic records set
A standard orthodontic records set pairs D0340 with two or three other diagnostic codes:
- D0330 is the panoramic image, a single curved film of both arches, the condyles, and the sinuses.
- D0340 is the cephalometric image, the standardized skull view for craniofacial measurement.
- D0350 is 2D oral or facial photographs, taken intra-orally or extra-orally.
- D0470 is diagnostic casts, the study models of the dentition.
Each is its own line under its own code. Don’t collapse them into one records charge on the claim, even when the practice quotes the patient a single records fee.
Why the name says “2D”
The “2D” separates a standard flat cephalometric film from a cephalometric view reconstructed from a 3D cone beam CT scan.
D0340 is the standalone 2D ceph. A cephalometric image taken from a CBCT capture belongs in the cone beam ranges, not D0340. Carriers cross-check the imaging type, so reporting a CBCT-derived view as D0340, or a standard 2D ceph as a cone beam code, is a mismatch. Code the image you actually captured.
Billing: records are often bundled, not paid line by line
The recurring question on D0340 is not how to code it but whether the carrier pays it separately. Plans handle orthodontic records in three ways:
- Some fold the ceph, the pano, and the photos into a single global records fee.
- Others bundle the records into the comprehensive orthodontic case and pay nothing extra for the diagnostic images.
- Some reimburse diagnostic records on their own lines, often with a frequency limit on how often a records set is covered.
Verify which applies, and store the answer on the patient’s ortho benefit record so estimates are right. If records are separately reimbursable, bill D0340, D0330, D0350, and D0470 on their own lines. If they are bundled into the case, don’t expect a separate payment on the ceph, and set the estimate accordingly.
For a Medicaid orthodontic pre-authorization, the ceph is part of the required documentation packet: panoramic (D0330), cephalometric (D0340), photographs (D0350), the diagnosis, and the treatment plan. The packet supports a medical-necessity score. Medicaid usually requires a scoring form, often an HLD index or a state-specific assessment, and without a qualifying score the case is denied as cosmetic. A records template that groups these items with the scoring form keeps the packet complete at submission.
When to bill D0340
Bill D0340 when a standard 2D cephalometric image is captured, with its measurement and analysis, typically as part of an orthodontic or surgical records workup. Common situations:
- Orthodontic diagnosis and treatment planning at the start of a case.
- A pre-authorization records packet, especially for Medicaid or a medically necessary case.
- Tracking skeletal change partway through or at the end of treatment.
Do not bill D0340 for:
FAQs
- What is the dental code for a cephalometric x-ray?
- D0340. It reports a 2D cephalometric radiographic image, a standardized side or front view of the skull taken with a cephalostat, together with its measurement and analysis. It is a core orthodontic record, used to measure the relationship of the teeth, jaws, and skull for diagnosis and treatment planning. Because the analysis is included, a separate tracing isn't billed on top of it.
- What's the difference between D0340, D0330, and D0350?
- They are three different orthodontic records, billed as separate codes. D0340 is the cephalometric image, the standardized skull view used for craniofacial measurement. D0330 is the panoramic image, a curved single film of both arches, the condyles, and the sinuses. D0350 is 2D oral or facial photographs, taken intra-orally or extra-orally. All three, often with diagnostic casts (D0470), make up a standard ortho records set.
- Why does the code say 2D cephalometric image?
- To separate a standard flat cephalometric film from a cephalometric view reconstructed from a 3D cone beam CT scan. D0340 is the standalone 2D ceph. A cephalometric view derived from a CBCT capture is coded in the cone beam ranges, not as D0340.
- Does insurance pay for D0340 separately?
- Often not. Many carriers treat orthodontic records as a group and either fold the ceph into a global records fee or bundle it into the comprehensive case. Others reimburse diagnostic records separately, sometimes with a frequency limit. Verify whether the plan pays orthodontic records separately, and how it wants them submitted, before billing D0340 as its own line.
- Is D0340 used in a Medicaid orthodontic pre-authorization?
- Frequently, yes. A Medicaid ortho pre-authorization usually needs a records packet: a panoramic image (D0330), a cephalometric image (D0340), photographs (D0350), the diagnosis, and the proposed treatment plan. Medicaid also typically requires a medical-necessity scoring form, often an HLD index or a state-specific assessment, and without a qualifying score the case is denied as cosmetic. The ceph supports the score; it is not a separate benefit on its own.
Related codes
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CDT codes are maintained by the American Dental Association. This page is an editorial billing guide, not the official ADA code descriptor. Verify current coverage policies with each carrier before submitting claims.