D0368 Dental Code: TMJ Cone Beam CT Series Billing

What D0368 covers

D0368 reports a cone beam CT study of the temporomandibular joints performed as a series, two or more exposures, where the provider who captured the images also interprets them and writes the report. A typical study images both joints, and protocols often add exposures in different condylar positions, closed and open, which is exactly the pattern the “series” language anticipates.

The clinical questions that send a case here are joint questions: degenerative condylar change, suspected trauma to the condyle, ankylosis, persistent dysfunction being worked up before treatment. That workup context is worth noting for the evaluation side of the visit too, since a complex temporomandibular assessment is one of the situations the detailed problem-focused evaluation, D0160, was written for; the imaging and the evaluation are separate services with separate codes.

Outside the field-of-view ladder

The other capture-and-interpretation cone beam codes are a ladder sorted by arch coverage: D0364 for a limited volume of less than one whole jaw, D0365 for the full lower arch, D0366 for the full upper arch, and D0367 for both jaws. D0368 does not sit on a rung. It is selected by what was studied, the joints, imaged as a multi-exposure series, regardless of how the individual volumes would size up on the ladder.

That placement answers the boundary question this code generates. A both-jaws volume taken for implant or orthodontic purposes will often include the condyles, and including them does not convert the scan into a TMJ study. One acquisition is one code, picked by its field of view. D0368 enters when the office performs a joint series as such: multiple exposures, joint-focused protocol, joint findings in the report.

When the capture and the read split

D0368 bundles two services, and the bundle holds only when one provider performs both. TMJ studies are read by outside radiologists more often than most dental cone beam, because condylar pathology is a diagnosis many general practices prefer not to sign alone. When the study goes out for interpretation, the coding splits: the capturing office reports D0384, the capture-only TMJ series code, and the reading practitioner reports D0391.

The pairing rule follows from the bundle. D0368 never appears alongside D0384 or D0391 for the same study, because that reports the interpretation twice. The general mechanics of split reads, including how carriers reprocess same-office capture-plus-interpretation pairs, are covered in when capture and interpretation split in the cone beam guide.

Coverage: the TMJ exclusion problem

D0368’s coverage question is really two stacked questions, and the TMJ one comes first. Many dental plans exclude TMJ services as a category, imaging included, before any cone beam policy is consulted. Arkansas Blue Cross’s published CDT 2026 procedure guidelines list D0368 as not a covered benefit outright, and it is not an outlier position. Plans that do entertain cone beam generally apply a necessity standard: Aetna’s radiographic examinations policy, for example, wants the suspected pathologic condition or anatomic concern documented in the clinical record as the justification for CBCT.

So verification for this code means asking the dental plan two things: whether TMJ diagnostic services are covered at all, and if so, what documentation the cone beam benefit requires. When the first answer is no, the medical plan is the realistic payer. Joint dysfunction, trauma, and degenerative disease are medical diagnoses, and the study crosses over with a CPT imaging code and an ICD-10 diagnosis rather than the CDT number, with its own necessity documentation. The workflow is laid out in billing cone beam to medical. Medical plans can carry TMJ exclusions of their own, so the crossover is a verification step, not a guarantee.

Documentation that supports the claim

Three things carry a D0368 claim, on whichever side it is billed:

• The series itself. The acquisition record should show the exposures, sides, and positions taken, since two or more exposures is the structural fact separating D0368 from the field-of-view codes.
• The indication. The suspected joint condition, in the clinical note, stated before the scan. This is the necessity language carrier policies ask for, and on medical claims it becomes the diagnosis code.
• The interpretation. A written report of joint findings signed by the provider who billed the combined code. If there is no in-office report, the office performed a capture, and the honest coding is D0384 plus an outside D0391.

In the PMS, keep D0368 and D0384 as separate, plainly labeled entries so a study sent out for reading cannot post as a one-provider service by default, and flag the code for benefits verification so the TMJ-exclusion check happens at scheduling. Broader setup for the whole family is in setting up cone beam codes in your PMS.