D0382 prior authorization | Premera Blue Cross of Washington

D0382, Cone beam CT image capture with field of view of one full dental arch - maxilla, with or without cranium These criteria do not imply or guarantee approval., is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: D0382
Description: Cone beam CT image capture with field of view of one full dental arch - maxilla, with or without cranium These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 587 Original policy

Premera Blue Cross of Washington prior authorization

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