D0210 Dental Code

D0210: Intra-Oral – Complete Series of Radiographic Images

As explained by the experts at DentalRevu, a complete series (D0210) dental code is frequently requested following the dentist’s oral examination of a new patient during the comprehensive oral examination (D0180) or (D0150) and enables the establishment of a diagnostic reference point. The dentist will order radiographic images based on the patient’s needs.

The entire series is often repeated every three to five years, depending on the patient’s needs. In some cases, a full series (D0210) is alternated with a panoramic photograph (D0330). Many payers are moving away from the more standard three-year benefit exclusion and toward a five-year reimbursement limitation.

This time duration varies according to plan, but the sequence and type of diagnostic imaging should be selected and prescribed on an individual basis by the physician. This conclusion is made after conducting a risk assessment, seeing the patient, and determining the medical necessity.

Images should not be taken based on the benefits or limits of the patient’s insurance plan. The patient record should include a written review of the diagnostic pictures collected by the dentist. If the radiographic evaluation is not documented, the payer may withhold payment or request reimbursement after an audit.

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What are the Warnings of the D0210 Dental Code?

Reporting an extraoral panoramic radiography picture (D0330) and bitewing images (D0272/D0273/D0274) as an intraoral complete series (D0210) is misleading. The dental clinic should not combine these two treatments (bitewings and panoramic film) and report them as a complete intraoral series.

A panoramic image is extraoral in nature, rather than intraoral. Always document precisely what you accomplish and the date on which the service was performed. Side note: It is not illegal or improper for an insurance company to “remap” a provided code to another code for the purpose of payment. This change is consistent with the contract language.

For payment purposes, payers commonly convert extraoral panoramic and intraoral bitewing pictures to a complete series (D0210). For additional information, see (D0330). However, the dentist will always determine the frequency of (D0210) or any other radiographic imaging depending on the patient’s needs as defined by FDA/ADA guidelines.

Notably, the term “usually” in the descriptor implies that the precise number of periapical and posterior images is less critical than the need to “show the crowns and roots of all teeth, periapical areas, and alveolar bone.”

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What are the Limitations of the D0210 Dental Code?

• Typically, a complete series (D0210) contains 14-22 periapical and posterior bitewing pictures. A complete pediatric series may consist of eight to nine periapical diagnostic images and two or four bitewing images. All crowns and roots of all teeth should be visible in the pediatric full series. Important note: Certain payers specify a minimum number of diagnostic pictures required to qualify as a complete series.
• If a number of bitewing and periapical are taken on the same service date and the fee for those images is equal to or higher than the fee for the complete series, the payer may only reimburse the fee for the complete series. The “once every three to five-year limitation” will be triggered if the complete series is paid for. If the complete series is reimbursed, a note must be included in the patient’s billing record for future reference.
• If a complete series (D0210) or panoramic image (D0330) is obtained and then replaced with a fresh complete series and/or panoramic image during the exclusion period (usually three or five years), the second radiographic image service will not be reimbursed. Both services are typically limited to three to five years.
• Numerous plans exclude bitewing radiography pictures taken after the service date of a panoramic radiographic image from coverage for a period of one year (D0330) or a complete series (D0210).

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Additional Information about the D0210 Dental Code

• Diagnostic-quality radiographic pictures should be dated and annotated in the patient’s record.
• The doctor should study and analyze diagnostic images. The interpretation should be documented in the patient’s chart.
• Diagnostic images are used in conjunction with the diagnosis procedure and must be deemed medically necessary.
• To avoid review errors, take care to note the location, left and right (upper/lower), if not indicated otherwise by the radiographic images.
• Important! If the payer audits you, inadequate and/or non-existent documentation of the need for diagnostic images may result in a demand for reimbursement of benefits for radiographic images taken. – – despite the fact that diagnostic images have been taken!
• Diagnostic pictures should be ordered by the physician based on the patient’s needs. Radiographic images should be ordered in accordance with the patient’s evaluation, and the precise need for the radiographic image(s) should be noted.