Diagnostic Radiographs. Diagnostic radiographs are x-rays taken to diagnose a dental disease, including their interpretations, and include: • Full-mouth (intraoral complete series) and panoramic films – Benefits are limited to a combined maximum of one every 60 months. • Bitewing films – Benefits are limited to two sets per Calendar Year. • Intraoral periapical films, as necessary for diagnosis. Benefits will not be provided for any radiographs taken related to the diagnosis of Temporomandibular Joint (TMJ) Dysfunction.
Diagnostic Radiographs. Diagnostic radiographs are x-rays taken to diagnose a dental disease, including their interpretations, and include: • Full-mouth (intraoral complete series) and panoramic films – Benefits are limited to a combined maximum of one every 36 months. • Bitewing films – Benefits are limited to four horizontal films or eight vertical films once every 12 months for adults. Benefits are limited to two sets every 12 months for Subscribers under age 19. However, Benefits are not available for bitewing films taken on the same date as full-mouth films or within 6 months of a complete series of radiographic images. • Periapical films, as Medically Necessary for diagnosis – Benefits are limited to six films every 12 months for adults. Frequency limitation does not apply to Subscribers under age 19.
Diagnostic Radiographs. Diagnostic radiographs are x‐rays taken to diagnose a dental disease, including their interpretations, and include: • Full‐mouth (intraoral complete series) and panoramic films - Benefits are limited to a combined maximum of one every 36 months. • Bitewing films - Benefits are limited to four horizontal films or eight vertic- al films once every 12 months. However, benefits are not available for bitewing films taken on the same date as full‐mouth films. • Periapical films, as necessary for diagnosis - benefits are limited to six every 12 months. Benefits will not be provided for any radiographs taken in conjunction with Tem- poromandibular joint (TMJ) Dysfunction.
