Diagnostic

D0220: Periapical First Radiographic Image

A radiograph of a single tooth or group of teeth showing the entire tooth and surrounding bone.

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When to use D0220

Diagnosing specific tooth pain

When a patient presents with localized pain and you need to evaluate the root, periapical area, and surrounding bone of a specific tooth.

Endodontic evaluation

Before, during, and after root canal treatment to assess the pulp chamber, root canals, and periapical pathology.

Trauma assessment

Evaluating a tooth after injury to check for root fracture, displacement, or alveolar bone damage.

Common D0220 denials

These are the denial reasons we see most often for D0220. Each one is preventable with proper documentation.

⚠ Exceeds frequency limitation

Many plans limit the total number of radiographic images per year. Track cumulative images across all visit dates.

⚠ Bundling with D0210

If a complete series (D0210) was taken the same day, individual periapicals are denied as included in the series.

⚠ Missing clinical indication

Document why this specific image was necessary. "Routine" is not sufficient justification.

Documentation checklist for D0220

Clinical indication

Document the specific reason the radiograph was needed (pain, swelling, trauma, follow-up).

Tooth number

Record which tooth or teeth the image covers.

Findings

Document what the radiograph revealed and how it affected the treatment plan.

Periapical radiograph billing rules

D0220 is the first periapical image. Each additional periapical taken during the same visit is billed as D0230. If you take four periapicals, you bill one D0220 and three D0230s.

Do not bill individual periapicals if you are taking a complete series. A complete series (D0210) includes all necessary periapical and bitewing images. Billing D0220 separately on top of D0210 will be denied as a duplicate.

Documentation tips for periapical radiographs

Every radiograph needs a clinical reason. "Patient due for x-rays" is not a valid indication. Document the symptom, finding, or clinical question that required the image. Examples: "Patient reports sharp pain on biting #19, periapical taken to evaluate for vertical root fracture" or "6-month post-endodontic evaluation #14, periapical to assess periapical healing."

The ADA recommends using selection criteria based on the patient's clinical condition rather than arbitrary time intervals. Payers increasingly audit radiograph frequency, and practices that take images on a strict time schedule without clinical justification face higher denial rates.

Related codes

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