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# CDT Code for Dental Full Mouth X Ray (FMX) Explained

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- December 20, 2024

In the current times, we cannot deny the importance of oral health. This is why oral evaluations like radiographs and X-rays have become crucial, allowing dentists to assess oral conditions thoroughly, otherwise not possible with the naked eye.

One important dental procedure that we’re going to discuss today is Full Mouth X-ray and its CDT code, i.e., D0210. This X-ray captures all the details and conditions of the teeth, gums, jaw bones, oral cavity, and alveolar bone.

## CDT Codes D0210, D0220, D0230 Error Probability

The problem lies in documenting the correct procedure code. There are many dental codes that are only one digit different and may create confusion for even the pros. For example, there are three codes – D0210, D0220, and D0230 – related to X-rays that are just a digit apart, and a slight error may lead to serious consequences like claims denial and patient dissatisfaction.

Going forward, we’ll discuss the D0210, Dental Code – Intraoral Complete Series of radiographic images, and the difference between D0210, D0220, and D0230. So, before going into detail, let’s tell you about Full Mouth X-ray (FMX) and the difference between similar dental codes.

## What Is a Full Mouth X-ray (FMX)?

In the dental world, D0210 stands for Full Mouth X-ray (FMX). Often considered an initial evaluation, an FMX helps dental specialists with a detailed picture of the patient’s teeth, gums, jawbones, etc. It is a combination of bitewing and periapical X-rays. A normal FMX contains 18 X-rays, however, it ranges between 14-22.

A complete picture of your mouth’s inside enables the dentist or hygienist to determine any health concerns and then create a treatment plan for it. The process only takes around 15 minutes and the dental staff or radiologist may use an apron around your torso to limit the harmful X-rays that may affect other nearby body parts.

## Why Are Full Mouth X-Rays Important?

Periodic Full Mouth Dental X-ray (FMX) holds significance in maintaining oral health for patients. It allows dentists and hygienists to thoroughly assess the dental and internal condition of the mouth and treat diseases that are causing trouble.

FMX assists dental specialists in ensuring that the treatments done earlier, like root canals, placing crowns, or fillings, are done right or not. Based on the condition, these X-rays assist the dentists to devise treatment plans for their patients. These include braces for crooked teeth, Invisalign, or wisdom tooth extraction.

### What do X-rays show?

- Tooth decay
- Receding Gums
- Teeth Cavities
- Under Existing Fillings
- Abscesses
- Bone Loss
- Boot infection
- Root Canal
- Cysts, tumors, or other treatable problems

## ADA Revision for The Dental Code D0210

The nomenclature and description of CDT code D0210 were revised by ADA, effective from 1st January 2023. According to the revision, this CDT code previously stood for Intraoral Complete X-rays and is now updated to ‘Intraoral comprehensive series of radiographic images’.

It is defined as ‘a radiographic survey of the whole month’ instead of a limited number of X-rays. CDT D0210 entails radiographs, like periapical, bitewing, and occlusal views. This series, when combined, gives a complete picture of all teeth, crowns, supporting structures, surrounding tissues, and alveolar views.

## D0210: Intraoral Complete Series Code

Also known as the Intraoral complete series code, the D0210 is also used after a dentist or hygienist examines the mouth’s internal condition of a new patient. Once done, the specialist may prescribe specific radiographs required to better assess the patient’s condition.

## Purpose of D0210

The specific dental code is broadly used as a diagnosis code for examining the patient’s dental condition. Dentists and hygienists use it in documentation to bill a complete assessment of a patient’s oral health. After this, the specialist will determine the next line of action, like they may recommend a porcelain/ceramic crown.

## Things to Remember When Billing X-Rays

It is important to ensure that the amount mentioned in the claim must be the same as received. When listing radiographic images, it is easy for specialists and even their staff to lose count of X-rays. Billing less number of X-rays than performed or mentioning more may lead to consequences.

We suggest you be careful when listing X-rays before and while submitting the claim. You can only use D0220 only once in a claim. For instance, if the patient has undergone four periapical X-rays, mention D0220 for one instance, and you can use D0230 multiple times for the remaining X-rays.

Lastly, billing guidelines suggest refraining from unbundling. Unbundling is when multiple X-rays are conducted in one visit and billed separately instead of FMX. Most practices do it to collect more revenue. Insurance companies are quite strict in these kinds of scenarios and consider it a fraudulent billing activity.

## Number of X-Rays Taken to Be Considered a Comprehensive Series (FMX)

It is the dentist who decides about the type and frequency of X-rays required for a comprehensive series. According to the American Dental Association, “There is not a ‘magical number’ or type of radiographs that determine when the ‘FMX’ procedure had been delivered.”

While in the revision, the removal of “…usually consisting of 14-22 periapical and bitewing images…” has been removed to simplify the criteria that determines the correct codes like D0210 and other similar codes, D0709, D0372, and D0387.

This change was done keeping in mind the unique circumstances of the radiographic image instead of a predefined image number. One important consideration is that D0210 is not billable and payable within six months of another instance coded by D0230, D0220, D0274, D0240, D0330, D0272, D0270. However, there’s an exception for emergency cases.

## Suggested Precautions for D0210

People associated with the dental industry, like experienced dentists and billing specialists, recommend precautions in the use of D0210 for Intraoral Complete Series of X-rays. We’ve mentioned these warnings for easy understanding.

- Avoid using extraoral panoramic radiography (D0330) with bitewing images (D0272, D0273, and D0274) and then reporting the combination as a thorough intraoral series (D0210).
- Insurance companies may sometimes consider extraoral panoramic and intraoral bitewing X-rays a complete series coded under D0210.
- The dentist or hygienist must determine the frequency of D0210 or any other radiographic imaging based on the needs of the patients and as suggested by the FDA and ADA.
- Billing reimbursement or coverage must not affect the clinical processes like the necessity of X-rays. Dentists must recommend correct imaging based on the requirements of the patient and not under the influence of the financial plan.
- To comply with regulations and avoid denials, people responsible for documentation must ensure a clear assessment of the diagnostic images taken after the initial visit. Not ensuring compliance and proper documentation may result in payors delaying or denying your reimbursements.

## Common CDT Codes for Dental X-Rays

### D0220: Intraoral – Periapical First Radiographic Imaging

In the dental billing world, D0220 is used primarily for one tooth, i.e., a specific area of the surface of the Crown or Root. D0220 comes with a limit of 1 X-rays per day. It isn’t payable with D0210.

### D0230: Intraoral – Periapical Each Additional Radiographic Image

Similar to D0220, this dental code focuses on one tooth, i.e., a specific area of the surface of the Crown or Root. However, it is an additional film and comes with a daily limit of up to 3 X-rays. Must be billed with D0220.

### D0270: Bitewing – Single Radiographic Image

In the claim form, D0270 represents a single radiographic image for upper and lower arc preside for patients above 2 years. It only represents the surface or area of the crown. D0270 comes with a limitation of one set of bitewings every six months, for one patient from the same provider. It isn’t payable with D0272, D0274, D0210, D0273, or up to six months after.

### D0272: Bitewings – Two Radiographic Images

This CDT code refers to two radiographic images per side for the upper and lower arch. It only represents the surface or area of the crown and is used for patients under the age of 10 years. D0272 is limited to one set of bitewings once in six months for one patient from the same provider.

### D0274: Bitewings – Four Radiographic Images

This CDT code refers to four radiographic images for the upper and lower arch per side. It only represents the surface or area of the crown and is used for patients under the age of 10 years. D0274 has a fixed limit of one set of bitewings per six months for one patient from the same provider.

## Complicated Dental Billing Simplified

Unable to get a hold of the complicated dental billing for radiographic images? You’re not the only one! X-ray billing and dental codes used to specify them for billing purposes are confusing and challenging for most dentists and their in-house staff.

If you want a permanent solution to counter confusing dental codes, partner with the best in the dental business – My Apex Dental RCM. We’ll simplify the complex codes without you fretting about billing issues and other administrative tasks.

Our highly experienced and professional dental billing team is well-versed in the nuances of CDT coding and insurance guidelines. They’ll write the script for your lasting success by accurately coding your X-rays. Let’s work together to enhance your credibility and revenue. Contact us today!

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