Summary & Overview
CPT 70355: Panoramic Jaw Radiograph for Fracture Evaluation
CPT code 70355 represents a panoramic X‑ray of the upper and lower jaws used to diagnose jaw fractures and related traumatic injuries. Nationally, this code is central to acute facial trauma workflows in emergency departments and outpatient imaging centers, enabling rapid evaluation of mandibular and maxillary integrity with a single diagnostic exposure. Proper coding ensures accurate reporting of radiology services tied to oral and maxillofacial injury care.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when 70355 is used, typical sites of service, and a summary of common modifiers and billing considerations. The publication outlines benchmarks and policy-relevant guidance on documentation and claim submission practices where available, and highlights areas where input data was not provided.
This resource is intended for billing managers, radiology and dental clinicians, and revenue cycle professionals seeking a national overview of how panoramic jaw radiography for fracture assessment is described, billed, and reimbursed across major payers.
Billing Code Overview
CPT code 70355 describes panoramic radiographic imaging of the upper and lower jaws performed to evaluate suspected fractures or traumatic injury to the mandible and maxilla. This service captures a single panoramic X‑ray that images the entire dental arch and adjacent structures for diagnostic assessment.
Service type: Diagnostic radiology — panoramic dental/jaw radiograph
Typical site of service: Emergency department or outpatient radiology/dental imaging suite, often used when patients present with facial trauma or suspected jaw fracture.
Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents to the emergency department after an assault with facial trauma. He reports jaw pain, malocclusion when biting, and swelling along the lower face. Physical exam reveals tenderness along the mandible and difficulty opening the mouth. A maxillofacial clinician orders panoramic radiography to evaluate for fractures of the mandibular body, condyle, or dental avulsion prior to definitive management.
The clinical workflow: triage and trauma evaluation → focused maxillofacial exam → decision for imaging to assess bony injury → obtain CPT 70355 panoramic radiograph (upper and lower jaws) in radiology or dental imaging suite → image interpretation by the reading provider (oral and maxillofacial surgeon, dentist with radiology privileges, or radiologist) → documentation of findings and incorporation into treatment plan (conservative care, closed reduction, surgical repair). Typical indications include suspected mandible fracture, temporomandibular joint dislocation, dental root fractures, or evaluation of bony alignment after trauma.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the interpreting physician's service separate from technical imaging. |