Sialography

Sialography is a radiographic technique specifically designed to evaluate the salivary glands and their ductal systems. During the procedure, a radiopaque contrast medium is introduced into the opening of a salivary duct, typically the parotid (Stensen's) or submandibular (Wharton's) duct. A series of radiographs are then taken to visualize the flow of the contrast material through the ductal system and into the gland itself. This imaging reveals obstructions such as sialoliths (salivary stones), strictures, ductal dilation, and other structural abnormalities that may be causing the patient's symptoms.

From a billing standpoint, sialography falls under the oral and maxillofacial surgery section of the CDT code set. The procedure is typically reported using D7951. Because sialography is not a routine diagnostic test, payers will expect clear documentation of medical necessity. The clinical record should include the patient's presenting symptoms, such as recurrent glandular swelling, pain during eating, dry mouth, or suspected infection, along with findings from the physical examination that prompted the imaging study. Without this supporting documentation, claims are vulnerable to denial on the basis that the procedure was not medically necessary.

Many general dental offices do not perform sialography in-house, as it requires specialized equipment and training. Patients are often referred to oral and maxillofacial surgeons or hospital-based radiology departments for the study. When a referral is involved, the billing team at the referring practice should ensure the referral is properly documented and that the specialist's findings are incorporated into the patient's treatment plan. For the specialist performing the procedure, understanding whether the patient's dental plan covers diagnostic imaging of this nature, or whether the claim should be submitted to medical insurance instead, is an important step in the pre-authorization process. Cross-coding to medical insurance using appropriate CPT codes may yield better reimbursement for this type of diagnostic study.