D0230 is the CDT code for each additional intraoral periapical radiographic image taken beyond the first. The first periapical image on a date of service is billed as D0220. Each subsequent periapical image taken that same day is billed separately as D0230. This code is used whenever clinical conditions require multiple periapical films in a single visit.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Get help with D0230 claims →Use D0230 for each periapical image taken after the first one on the same date of service. Always pair it with D0220 on the claim. D0230 is billed as multiple units when more than two periapical images are taken. For example, three periapical images on the same day would be billed as one D0220 and two units of D0230.
Common clinical scenarios: Endodontic evaluation requiring views of multiple teeth or from different angles. Pre-surgical assessment before implant placement or extraction when localization is needed. Evaluation of multiple symptomatic teeth in a quadrant. Post-operative evaluation after endodontic treatment across multiple canals or teeth. Periodontal evaluation of localized bone loss in multiple areas.
Do NOT use D0230 without D0220: D0230 is the additional image code. It cannot stand alone on a claim. If only one periapical image is taken, bill D0220 only. Do not bill D0230 on the same claim as a full mouth series (D0210) because all periapical images are included in that series.
Most dental plans limit the total number of radiographs per year or per visit. When the combined count of periapical images exceeds the plan's allowed limit, the excess D0230 units are denied. Check the patient's radiograph benefit before taking multiple periapical films and document clinical necessity in the record for all images taken.
D0230 cannot be billed without a corresponding D0220 on the same date. It is the "additional image" code and requires the first periapical image (D0220) to be on the same claim. If D0220 is accidentally left off the claim or denied separately, D0230 claims will follow with a denial or processing error.
D0210 covers a complete series of periapical and bitewing images. Billing D0220 or D0230 on the same date as D0210 results in denial because the individual periapical images are included in the full mouth series. Do not mix these codes on the same date of service.
Claims with a high number of D0230 units on a single date of service may be reviewed. Payers want to see that the number of images was clinically warranted. If the clinical notes do not clearly explain why multiple periapical views were needed, the excess units are at risk of denial on review.
Confirm that the first periapical image is billed as D0220 on the same date of service. D0230 units are for each image after the first. The claim must include D0220 before D0230 units are valid.
Document in the clinical note why more than one periapical image was necessary. State which teeth or areas were imaged and the clinical question each view was taken to answer. This supports the units billed.
Record the findings from each image in the clinical note. Noting "no significant findings" or describing pathology observed on each film shows the images were reviewed and clinically useful.
The number of D0230 units billed must equal the number of additional periapical images taken beyond the first. If three periapical images were taken, bill one D0220 and two D0230 units. Mismatching the units to images taken is a billing error.
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Learn about our billing servicesD0230 is the CDT code for each additional intraoral periapical radiographic image beyond the first. When multiple periapical films are taken on the same date of service, the first is billed as D0220 and each additional image is billed as a separate unit of D0230.
D0220 is the code for the first periapical image. D0230 is billed for each additional periapical image taken after the first on the same date. Three periapical films on one visit would be billed as one D0220 and two D0230 units.
Common reasons include payer frequency limits on total radiographs per visit or per year, billing D0230 without a corresponding D0220, billing D0230 on the same date as a full mouth series (D0210), and insufficient clinical documentation for the number of images taken.
The clinical note should state why multiple periapical images were needed, identify the teeth or regions imaged, and document findings from each film. The number of units billed must match the number of additional images taken beyond the first.
CDT does not impose a per-visit limit, but most payers apply their own frequency and quantity controls. Claims with many D0230 units on a single date may be reviewed. Document clinical justification clearly for all images taken.
No. D0210 is a full mouth radiographic series that includes all periapical images. Billing D0220 or D0230 on the same date as D0210 will result in denial because the individual periapical images are already included in the full mouth series.
Search all 206 CDT codes in our dental coding guide.