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CDT-2021 D0210

INTRAORAL - COMPLETE SERIES OF RADIOGRAPHIC IMAGES

A radiographic survey of the whole mouth, usually consisting of 14-22 periapical and posterior bitewing images intended to display the crowns and roots of all teeth, periapical areas and alveolar bone.  

© 2020 American Dental Association

warning
  1. It is misleading to report an extraoral panoramic radiographic image (D0330) and bitewing images (D0272/D0273/ D0274) as an intraoral complete series (D0210). The dental office should not combine these two procedures (panoramic film and bitewings) and report as an intraoral complete series. A panoramic image is extraoral, not intraoral. Always report exactly what you do and the 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. Payers routinely convert the extraoral panoramic images and intraoral 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 is always determined by the dentist based on the needs of the patient as determined by ADA/FDA guidelines. 
  2. Note that the word “usually” in the descriptor indicates that the exact number of periapical and posterior images is not as important as the need to “display the crowns and roots of all teeth, periapical areas and alveolar bone.”

Comments

 
    1. A complete series (D0210) is inclusive of bitewings, but bitewings are not necessarily required. The complete series is intraoral
    2. A complete series (D0210) is most often ordered after the oral evaluation of the new patient by the dentist at the comprehensive oral evaluation (D0150) or (D0180). Radiographic images are ordered by the dentist per the needs of the patient. A complete series (D0210) helps to determine a diagnostic baseline. The complete series is generally repeated on a three to five-year basis per the needs of the patient. In some cases, a full series (D0210) is alternated with a panoramic image (D0330) every three or five years.  Many payers are trending toward a five-year reimbursement limitation rather than the more traditional three-year benefit exclusion. This limitation period varies among plans. 
    3. 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 evaluation in the chart, the payer may deny payment of the claim or ask for reimbursement in the event of an audit.
    4. For intraoral – complete series of radiographic images, image capture only, see D0709.

Limitations

 
    1. A complete series usually consists of 14-22 periapical and posterior bitewing images. A pediatric complete series may consist of 8-9 periapical diagnostic images and either two or four bitewing images. The pediatric full series should display the crowns and roots of all teeth. Note: Some payers require a specific number of diagnostic images to qualify as a complete series. 
    2. 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 complete series, the fee reimbursed by the payer may be limited to that of the complete series. The payment of the complete series will trigger the “once every three to five-year limitation.” If a complete series is reimbursed, a notation should be made in the patient’s billing record for future reference. 
    3. If either a complete series (D0210) or panoramic image (D0330) is taken and then a new complete 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.
    4. Many plans have a one-year limitation exclusion for bitewing radiographic images taken after the service date of a complete series (D0210) or a panoramic radiographic image (D0330)

Additional Information

 
    1. Diagnostic images are adjunctive to the diagnosis process, and must be medically necessary.
    2. Diagnostic images should ordered by the doctor according to the needs of the patient.  This order for radiographic images should follow the evaluation of the patient and the specific need for the radiographic image(s) should be documented.
    3. Diagnostic images should be viewed and interpreted by the doctor.  Documentation of the interpretation should be in the patient’s chart. 
    4. Read FDA/ADA diagnostic image guidelines at:  http://www.ada.org/2760.aspx  or https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/selection-patients-dental-radiographic-examinations 
    5. Important!  Poor and/or non-existing documentation of the need for diagnostic images may result in a demand for repayment of benefits for radiographic images taken if audited by the payer.- - even though the diagnostic images were taken!
    6. Radiographic images should be of diagnostic quality, dated, and labeled in patient’s record.
    7. Be careful to note the location, left and right (upper/lower), if not otherwise indicated by the radiographic images  to avoid review errors.

Images

 
  • image description
 
close Courtesy DEXIS, LLC and DEXIS®

This is a complete series (including bitewings).

Courtesy DEXIS, LLC and DEXIS®

D6980

REVISED CODE

Fixed Partial Denture Repair

A single cast metal crown restoration that is retained, supported and stablized by an abutment on an implant; may be screw retained or cemented.

NOTE: May be orthodontic related