D0240 dental code: intraoral occlusal radiographic image.

D0240 is the CDT code for an intraoral occlusal radiographic image. The film or sensor is placed flat on the biting surface and the patient bites down, capturing a wide-field view of either arch. It is used when periapical images cannot cover the required area. Common in pediatric patients, pathology evaluation, and locating impacted or supernumerary teeth.

Last updated June 2026 ยท Reviewed by the PracticeAlpha billing team

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Code
D0240
Category
Diagnostic
Image Type
Intraoral Occlusal
Coverage
Diagnostic (100%)

When to use D0240

Pediatric imaging

Occlusal films are valuable in young children who cannot tolerate periapical films. They capture developing dentition, unerupted teeth, and a broad view of the arch without patient positioning difficulties.

Pathology and hard tissue lesions

Useful for detecting salivary duct calculi, tori, supernumerary teeth, cysts in the floor of the mouth or palate, and fractures that span across a large portion of the arch.

Locating impacted or displaced teeth

Occlusal images help confirm the buccal or lingual position of impacted canines or supernumerary teeth when used alongside periapical images. The wide field of view is useful for surgical planning.

Do NOT use D0240 for: Standard single-tooth periapical images (use D0220 or D0230). Bitewing images for interproximal caries detection (use D0270, D0272, or D0274). Panoramic images covering both arches (use D0330). Full-mouth series (use D0210).

Why D0240 claims get denied

Bundling with FMX or PAN

D0240 billed on the same date as D0210 (full-mouth series) or D0330 (panoramic) is commonly bundled by payers. Insurers consider the occlusal image redundant when a comprehensive series was already taken the same day. If clinical circumstances genuinely require both, document why the occlusal view added diagnostic information the series did not capture.

Frequency limit exceeded

Some plans count D0240 against the same annual intraoral x-ray allowance as D0220 and D0230. If the patient has already used their allowed periapical images for the year, D0240 may be denied on frequency grounds even though it is a different technique. Check benefit limits before taking the image.

Missing clinical justification

Routine documentation for D0240 should state the clinical reason for ordering the occlusal view. "Occlusal x-ray taken" is not sufficient. The record should specify what was being evaluated (impacted tooth location, floor-of-mouth lesion, etc.) so the payer can confirm medical necessity.

Code submitted as extraoral

D0240 is specifically an intraoral occlusal image. Extraoral projections use different codes. If the image was taken with the film outside the mouth, D0240 is the wrong code. Misclassifying the technique can trigger a denial or audit.

Documentation checklist for D0240

Clinical reason for the occlusal view

Record why an occlusal image was selected over a periapical. Examples: pediatric patient unable to tolerate periapical positioning, evaluating a floor-of-mouth lesion, localizing an impacted canine.

Arch and orientation documented

Specify maxillary or mandibular and whether the image was a standard occlusal or topographic occlusal view. Clear notation prevents coding ambiguity.

Date and provider

Confirm the image date matches the claim date of service. The treating or supervising provider must be identified in the record per ADA and payer requirements.

Radiograph retained in patient record

The actual image must be available for audit or payer request. Digital images should be stored in the patient's imaging chart with the corresponding date.

Findings documented

Record your interpretation of the image, even briefly. What was seen or ruled out? Noting findings closes the loop between the image and the clinical note, which strengthens the record if the claim is reviewed.

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Related diagnostic imaging codes

D0220 First periapical radiographic image
D0230 Each additional periapical radiographic image
D0260 Extraoral occlusal radiographic image
D0270 Single bitewing radiographic image
D0210 Full-mouth radiographic series
D0330 Panoramic radiographic image

D0240 FAQ

What is D0240 dental code?

D0240 is the CDT code for an intraoral occlusal radiographic image. The film or sensor is placed on the biting surface of the arch and the patient bites down, producing a large-field view used to evaluate the palate, floor of the mouth, developing teeth, and wide-area pathology.

When is D0240 used instead of periapical x-rays?

D0240 is used when a wide-field intraoral view is needed that a periapical film cannot cover. Common uses include pediatric arch imaging, locating supernumerary or impacted teeth, detecting salivary stones, and evaluating tori or cysts across a broad area of the jaw.

What is the difference between D0240 and D0220?

D0220 is for a single periapical image focused on one tooth or a small area. D0240 is an occlusal image taken with a larger film placed on the biting surface, covering a wider portion of the arch. Different technique, different diagnostic purpose, and different film size.

Does D0240 require a narrative for insurance?

Most plans do not require a narrative for routine diagnostic imaging, but clinical notes must support the need. If D0240 is billed on the same date as a full-mouth series or panoramic, payers may bundle it and require documentation to justify separate billing.

Can D0240 be billed with a full-mouth series?

Most payers consider D0240 bundled into D0210 when taken on the same date. If both were clinically necessary, document the specific reason the occlusal view added diagnostic value beyond the series. Without that documentation, the D0240 will typically be denied or bundled.

How often does insurance cover D0240?

Frequency limits vary by plan. Many plans treat D0240 as part of the overall intraoral x-ray allowance alongside D0220 and D0230. Some plans allow D0240 as needed with clinical justification, while others cap the total number of intraoral images per benefit period regardless of type.

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