Billing Guide for D0210 (Full Mouth X-ray or Intraoral - Comprehensive Series of Radiographic Images)
Solutions
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Description
Billing Guidelines, Tips and Reminders for D0210 (Intraoral - Comprehensive Series of Radiographic Images)
February 02, 2025
A radiographic survey of the whole mouth intended to display the crowns and roots of all teeth, perapical areas, interproximal areas and alveolar bone edentulous areas.
WARNING
It is misleading to report an extra-oral panoramic radiographic image (D0330) and bitewing images (D0272/D0273/ D0274) as an intra-oral comprehensive series (D0210). The dental office should not combine these two procedures (panoramic film and bitewings) and report as an intra-oral comprehensive series. A panoramic image is extra-oral, not intra-oral. Always report exactly what you do and the correct service date the service is performed. Note: It is not illegal or improper for an insurance company to "remap" a submitted code to another code for payment purposes. This modification is in accordance with the contract language. Payors routinely convert the extra-oral panoramic images and intra-oral bitewing images to a complete series (D0210) for reimbursement purposes. See (D0330) for further details. However, the frequency of (D0210) or any other radiographic imaging should always be determined by the dentist based on the needs of the patient and ADA/FDA guidelines; not by insurance frequency limitations. Note: The date of service of any radiograph is the date they are interpreted, not the date they are taken. However, when panoramic and bitewing radiographs are taken on the same service date but then routinely split into different dates for interpretation in order to circumvent remapping by the payor to comprehensive series (D0210), this may be seen as a misrepresentation of treatment dates to gain increased reimbursement.
COMMENTS
1. What constitutes a comprehensive series of radiographs may vary from patient to patient. The critical component is that it should be a combination of intra-oral diagnostic quality radiographs that display the crown and roots of all teeth, periapical areas, interproximal areas, and alveolar bone, including edentulous areas.
2. A comprehensive series (D0210) is inclusive of bitewings, but bitewings are not necessarily required. The comprehensive series is intra-oral.
3. A comprehensive series (D0210) is most often ordered after the oral evaluation of the new patient by the dentist at the comprehensive or comprehensive periodontal oral evaluation (D0150) or (D0180). Radiographic images are ordered by the dentist per the needs of the patient. A comprehensive series (D0210) helps to determine a diagnostic baseline. The comprehensive series (D0210) is generally repeated on a three to five-year basis per the needs of the patient. In some cases, a full series is alternated with a panoramic image (D0330) every three or five years. Many payors are trending toward a five-year reimbursement limitation rather than the more traditional three-year benefit exclusion. This limitation period varies among plans.
4. The type and sequence of diagnostic images should be determined and ordered by the doctor on a patient-by-patient basis. This determination is based on risk assessment, observation, and medical necessity. Images should not be taken based on the patient's plan benefits or limitations. Patient documentation should contain the dentist's written evaluation of the diagnostic images taken. If there is no documentation of the radiographic interpretation in the chart, the payor may deny payment of the claim or ask for reimbursement in the event of an audit.
5. For intraoral - comprehensive series of radiographic images, image capture only, see D0709.
6. For intraoral tomosynthesis - comprehensive series of radiographic images, see D0372. For image capture only, see D0388.
LIMITATIONS
1. If a number of periapicals and bitewing images are taken on the same service date and the fee for those images is equal to or greater than the comprehensive series, the fee reimbursed by the payor will often be limited to that of the comprehensive series. The payment of the comprehensive series will trigger the "once every three to five-year limitation." If a comprehensive series is reimbursed, a notation should be made in the patient's billing record for future reference.
2. If either a comprehensive series (D0210) or panoramic image (D0330) is taken and then a new comprehensive series and/or panoramic image is taken during the exclusion period (typically three or five years), the second radiographic image service will not be reimbursed. Both services are usually subject to the same three to five-year limitation.
3. Many plans have a one-year limitation exclusion for bitewing radiographic images taken after the service date of a comprehensive series (D0210) or a panoramic radiographic image (D0330).
This is a comprehensive intra-oral series (including bitewings).
WARNING
It is misleading to report an extra-oral panoramic radiographic image (D0330) and bitewing images (D0272/D0273/ D0274) as an intra-oral comprehensive series (D0210). The dental office should not combine these two procedures (panoramic film and bitewings) and report as an intra-oral comprehensive series. A panoramic image is extra-oral, not intra-oral. Always report exactly what you do and the correct service date the service is performed. Note: It is not illegal or improper for an insurance company to "remap" a submitted code to another code for payment purposes. This modification is in accordance with the contract language. Payors routinely convert the extra-oral panoramic images and intra-oral bitewing images to a complete series (D0210) for reimbursement purposes. See (D0330) for further details. However, the frequency of (D0210) or any other radiographic imaging should always be determined by the dentist based on the needs of the patient and ADA/FDA guidelines; not by insurance frequency limitations. Note: The date of service of any radiograph is the date they are interpreted, not the date they are taken. However, when panoramic and bitewing radiographs are taken on the same service date but then routinely split into different dates for interpretation in order to circumvent remapping by the payor to comprehensive series (D0210), this may be seen as a misrepresentation of treatment dates to gain increased reimbursement.
COMMENTS
1. What constitutes a comprehensive series of radiographs may vary from patient to patient. The critical component is that it should be a combination of intra-oral diagnostic quality radiographs that display the crown and roots of all teeth, periapical areas, interproximal areas, and alveolar bone, including edentulous areas.
2. A comprehensive series (D0210) is inclusive of bitewings, but bitewings are not necessarily required. The comprehensive series is intra-oral.
3. A comprehensive series (D0210) is most often ordered after the oral evaluation of the new patient by the dentist at the comprehensive or comprehensive periodontal oral evaluation (D0150) or (D0180). Radiographic images are ordered by the dentist per the needs of the patient. A comprehensive series (D0210) helps to determine a diagnostic baseline. The comprehensive series (D0210) is generally repeated on a three to five-year basis per the needs of the patient. In some cases, a full series is alternated with a panoramic image (D0330) every three or five years. Many payors are trending toward a five-year reimbursement limitation rather than the more traditional three-year benefit exclusion. This limitation period varies among plans.
4. The type and sequence of diagnostic images should be determined and ordered by the doctor on a patient-by-patient basis. This determination is based on risk assessment, observation, and medical necessity. Images should not be taken based on the patient's plan benefits or limitations. Patient documentation should contain the dentist's written evaluation of the diagnostic images taken. If there is no documentation of the radiographic interpretation in the chart, the payor may deny payment of the claim or ask for reimbursement in the event of an audit.
5. For intraoral - comprehensive series of radiographic images, image capture only, see D0709.
6. For intraoral tomosynthesis - comprehensive series of radiographic images, see D0372. For image capture only, see D0388.
LIMITATIONS
1. If a number of periapicals and bitewing images are taken on the same service date and the fee for those images is equal to or greater than the comprehensive series, the fee reimbursed by the payor will often be limited to that of the comprehensive series. The payment of the comprehensive series will trigger the "once every three to five-year limitation." If a comprehensive series is reimbursed, a notation should be made in the patient's billing record for future reference.
2. If either a comprehensive series (D0210) or panoramic image (D0330) is taken and then a new comprehensive series and/or panoramic image is taken during the exclusion period (typically three or five years), the second radiographic image service will not be reimbursed. Both services are usually subject to the same three to five-year limitation.
3. Many plans have a one-year limitation exclusion for bitewing radiographic images taken after the service date of a comprehensive series (D0210) or a panoramic radiographic image (D0330).
This is a comprehensive intra-oral series (including bitewings).