Understanding Dental Code D0270

When to Use D0270 dental code

The D0270 dental code is designated for a single bitewing radiographic image. Bitewing X-rays are a crucial diagnostic tool in dentistry, allowing providers to detect interproximal caries, assess existing restorations, and evaluate bone levels. Use D0270 when only one bitewing image is necessary—typically in cases where a patient has localized dental concerns, limited dentition, or when a full set of bitewings is not clinically justified. This code should not be used for multiple bitewing images; for two, three, or four images, refer to D0272, D0273, or D0274 respectively.

Documentation and Clinical Scenarios

Accurate documentation is essential for proper reimbursement and compliance. When billing D0270, ensure the patient’s chart clearly indicates the clinical reason for a single bitewing, such as monitoring a specific area of decay or following up on a restoration. Include the date, tooth numbers or areas imaged, and a brief narrative supporting medical necessity. Common clinical scenarios include:

• Evaluating a suspicious area between two teeth
• Monitoring a previously restored tooth for recurrent decay
• Assessing bone height in a localized region

Always ensure that the radiograph is saved in the patient’s record and is of diagnostic quality, as insurance payers may request a copy during claim review or audit.

Insurance Billing Tips

To maximize reimbursement and minimize denials for D0270, follow these best practices:

• Verify frequency limitations: Most dental plans limit the number of bitewing images covered per benefit period. Check the patient’s eligibility and plan details before taking and billing the X-ray.
• Submit supporting documentation: If the claim is for a single bitewing rather than the standard set, include a brief narrative explaining the clinical rationale. Attach the radiographic image if required by the payer.
• Use accurate CDT coding: Do not upcode (bill for more images than taken) or downcode (use D0270 for multiple images). Accurate coding prevents claim delays and potential compliance issues.
• Track EOBs and AR: Monitor Explanation of Benefits (EOBs) for denials or reductions related to frequency or lack of documentation. Promptly follow up on denied claims with additional information or a formal claim appeal if justified.

Example Case for D0270

Consider a patient who presents with sensitivity between teeth #13 and #14. The dentist determines that a single bitewing is needed to evaluate for interproximal decay. The clinical note documents the patient’s complaint, the dentist’s findings, and the justification for a single image. The dental biller verifies that the patient’s insurance plan allows one bitewing per six months and submits the claim using D0270, attaching the radiograph and a brief narrative. The claim is processed without delay, and payment is received as expected. This scenario highlights the importance of clear documentation, insurance verification, and correct CDT coding for efficient revenue cycle management.