03 Sep Code Tip: D0210 Intra-Oral—Complete Series of Radiographic Images
Insurance companies will dictate as to what their policies allow as a complete radiographic series. This may conflict with the dentist’s interpretation. If you want the insurance to pay and you are in network than you must abide by the policy provisions.
Reporting an extra-oral panoramic radiograph image (D0330) and bitewing images taken at the same time (D0272,D0273 and D0274 is often considered misleading by the payers. This is because the panoramic image is extra-oral not intra-oral. D0210 is “intra-oral” only.
The insurance companies will often remap the codes as a modification of the contract language to allow for a D0210 for reimbursement purposes. The complete series includes bitewings so there isn’t an extra payment for those. Images should never be taken based on what the plan will pay but for the medical necessity of the patient.
The type and sequence is always determined by the doctor on a patient by patient basis after risks, observations and dental history are taken into consideration. Documenting the medical necessity of all radiographs should be a routine habit.
Dental Billing Tips and News for Pros; Edition #139