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DPAP 200

Dental X-ray Requirements

Provider Administrative Policy

Policy Date
January 2012
Revised/May 2013
Provider Type(s)
All Providers  


Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Blue Cross of Idaho works diligently on behalf of our members to develop contracting relationships with Idaho dental providers and Blue Cross Blue Shield dental affiliates (national Dental Grid).



Dental X-ray Requirements

When Blue Cross of Idaho requires an X-ray to determine dental benefits, please send X-ray copies only. As a standard business practice, we will no longer return x-rays unless it's accompanied by a stamped, self-addressed envelope, so please do not submit any singular, original films. The only services requiring an X-ray copy are:

 CDT Code(s)  Dental Procedure(s)

2510 - 2544
2610 - 2644
2650 - 2664
6600 - 6615



2710 - 2794
2929 - 2934
2960 - 2962

Crowns (multiple crowns, and all anterior crowns)
(X-ray not required for single posterior crowns)
2952 - 2954
6970 - 6972
6976 - 6977 
Post and Core
(X-ray not  required if history of root canal on same tooth)
2960 - 2962  Labial Veneers 

Clinical Crown Lengthening (anterior teeth)
(X-ray not required for crown lengthening on posterior teeth) 

6010 - 6050
6056 -6079
6090 - 6094

Implant Services 

You may submit X-ray copies, narratives, explanations of benefits or other claims documentation using the National Electronic Attachment's (NEA) internet-based delivery system, FastAttachTM. FastAttach is easy to use and inexpensive. It reduces the risk of losing documentation, decreases postage expense and works with all Window-based practice management systems. FastAttach also stores your images in a secure repository so you can resend as needed. For more information on FastAttachTM, please contact NEA directly at or 800-782-5150, option 2.

Policy History

Date Action Reason
May 2013 Revised Deleted codes that no longer require x-ray and added codes requiring x-rays.
December 2012 Revised Added 2013 CDT 2929

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