When it comes to dental coding, things can get confusing. After all, many codes are only a digit apart. For instance, when billing x-rays, three similar codes are D0210, D0220, and D0230. They can easily be confused and lead to coding errors. In this ongoing series, we discuss common coding errors, focusing today on D0210, D0220, and D0230.
What is the difference between D0210, D0220 and D0230?
According to the ADA, D0210 is the dental code for “intraoral – comprehensive series of radiographic images.” D0220 is the code for “intraoral – periapical first radiographic image.” D0230 is the code for “intraoral – periapical additional radiographic image.” The difference between the three is the amount and order of the x-rays completed.
What is a full mouth x-ray?
In dental offices, code D0210 is commonly referred to as a full mouth x-ray (FMX). Usually completed at an initial exam, an FMX provides the dentist with a complete overview of the patient’s teeth. An FMX includes a combination of bitewing and periapical x-rays. A typical FMX contains 18 x-rays but can range anywhere from 14 to 22.
What is a periapical x-ray?
A periapical x-ray is an x-ray that shows the entire length of the tooth from the root tip to the crown. It allows the dentist to see the entire tooth and surrounding tissue to determine decay, damage, gum disease, bone loss, or other issues.
Has the ADA revised D0210?
Yes, in 2023 the ADA revised code D0210. Previously it was considered “a complete series of radiographic images” and listed a specific amount of x-rays (14-22) that constituted it. It has now been updated to “a comprehensive series of radiographic images” and is now defined as “a radiographic survey of the whole mouth” rather than a specific number of x-rays.
Did you know that each year brings new updates to CDT codes? This year there were 16 CDT code changes. To keep up with them, it’s best to have a reference guide on hand. Dental Coding with Confidence is the industry standard and includes the 2024 updates.
What should I remember when billing x-rays?
When billing x-rays, check to make sure that the amount billed matches the amount taken. When listing multiple x-rays it can be easy to lose count and bill one too many. Always double-check your numbers before submitting the claim.
Also, D0220 can only be used once per claim. For example, if you are billing 4 periapical x-rays, list D0220 once and D0230 three times.
In addition, avoid unbundling x-rays. Unbundling occurs when all x-rays taken during an appointment are billed separately rather than as an FMX to receive a larger reimbursement. Insurance companies consider this fraud and will almost always downgrade the payment to an FMX.
Do frequency limits apply to x-rays?
Frequency limits do apply to x-rays. As an FMX is ordinarily completed at an initial exam, it’s usually covered once every 3-5 years, depending on the patient’s plan specifications. Bitewings are usually limited to a set amount per year. It varies from plan to plan but typically coverage is 1-2 times per 12-month period. Frequency limits are less common for periapicals.
When billing x-rays, the dental codes are so similar that they are easily confused. If you want to avoid any confusion, consider partnering with eAssist. Our Success Consultants are knowledgeable about the various nuances of CDT codes and will ensure your x-rays are billed correctly. To learn more, schedule a consultation here.
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