X007 – Temporomandibular joints - four views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
This service provides for a radiological examination of the temporomandibular joints. The procedure requires four distinct views, which must include images taken with the patient's mouth both open and closed to properly evaluate the joint's range of motion and anatomical integrity. Note: Dental x-rays of the teeth are not an insured benefit under OHIP. See page for details.
When to Use
- Use X007 when evaluating TMJ internal derangement or suspected disc displacement where four distinct views (open and closed mouth) are clinically required to assess joint excursion.
- Use X007 for assessing structural integrity or degenerative changes in the TMJ following trauma, provided the clinical indication is joint-specific and not related to dental pathology.
Common Pitfalls
- Billing X007 for dental or periodontal imaging is a non-insured service and will result in audit recovery; ensure the requisition specifically targets the joint anatomy.
- Failure to document the four required views (open and closed mouth) in the technical report is a common audit trigger for rejecting the technical component (X007B).
- Confusing X007 with general skull or facial bone series (e.g., X006) leads to claim rejections; X007 is specific to the temporomandibular joint articulation.
Billing Tips
- Always split your claim into the technical component (X007B) and the professional component (X007C) to ensure accurate processing of the facility and physician fees.
- If the patient is under 16, ensure the age premium is applied to the claim to capture the appropriate percentage increase for the diagnostic radiological examination.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
The physician submitting a claim for the technical component is responsible for the complete quality assurance process for all elements of the technical component of the service, including data acquisition, reporting, and record keeping. The physician must be able to demonstrate this upon request by the MOH.
All insured services must be documented in the medical record to establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
Dental x-rays of the teeth are not an insured benefit.
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