Understanding Dental Code D0273

When to Use D0273 dental code

The D0273 dental code is a CDT (Current Dental Terminology) code used to report bitewing radiographs—specifically, three radiographic images. Bitewings are essential for detecting interproximal caries, monitoring bone levels, and assessing restorations. Use D0273 when three separate bitewing images are taken during a single visit, commonly for adult patients with moderate to high caries risk or when comprehensive diagnostic information is needed beyond the standard two or four bitewing series.

Documentation and Clinical Scenarios

Proper documentation is crucial for successful reimbursement and compliance. When using D0273, ensure the patient’s chart includes:

• Clinical rationale for taking three bitewings (e.g., caries risk, history of restorations, periodontal concerns).
• Date and tooth numbers or areas imaged.
• Provider’s diagnostic notes supporting the need for three images instead of the more common two or four.
• Image storage in the patient’s digital record for future reference and potential insurance audits.

Common scenarios include patients with uneven spacing, localized periodontal disease, or when previous radiographs indicate the need for targeted imaging. Always document the specific reason for deviating from standard bitewing protocols.

Insurance Billing Tips

To maximize reimbursement and minimize claim denials for D0273:

• Verify coverage during insurance verification, as some plans limit the frequency or number of bitewing images per benefit period.
• Submit clear clinical documentation with the claim, especially if the number of images deviates from the patient’s previous history or plan norms.
• Attach radiographic images when requested by the payer or if the claim is flagged for review.
• If denied, appeal with detailed notes explaining the clinical necessity and referencing the patient’s risk factors or diagnostic findings.
• Be aware of related codes, such as D0272 (two bitewings) and D0274 (four bitewings), and ensure you select the code that matches the actual number of images taken.

Accurate coding and thorough documentation are key to reducing accounts receivable (AR) delays and ensuring compliance with payer requirements.

Example Case for D0273

Scenario: An adult patient with a history of interproximal caries and several posterior restorations presents for a recall exam. The provider determines that three bitewing images are necessary to adequately visualize all areas of concern, given the patient’s unique arch spacing and restorative history.

Best Practice Steps:

1. Document the patient’s caries risk and restorative history in the clinical notes.
2. Record the specific areas imaged and the rationale for three images.
3. Code the procedure as D0273 on the claim form.
4. Submit supporting documentation and images if required by the payer.
5. Monitor the claim status and respond promptly to any requests for additional information or appeals.

This approach ensures accurate billing, supports medical necessity, and streamlines the reimbursement process for your dental practice.