D0220 dental code explained
D0220 usually means one detailed image of a specific tooth and its surrounding root and bone, taken to get a close look at a particular area of concern
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What D0220 means
This image is commonly taken when a dentist wants to examine a specific tooth more closely — for example, to check the root, look for an infection, or evaluate a tooth before or after a procedure. It is often taken alongside a limited exam when a patient comes in with a specific complaint.
Average negotiated rates
Benchmarks are based on published negotiated-rate data available to MyBillRx. Your actual allowed amount depends on plan, network, geography, provider contract, and whether the claim is processed in-network.
What insurance typically checks
- • Check whether your plan limits the number of individual periapical images covered per visit or per year, as some plans cap the total number of D0220 claims allowed.
- • Confirm whether D0220 is covered when taken on the same day as a full-mouth series (D0210), since some insurers will not pay for both together.
- • Verify that the tooth number or area imaged is documented on the claim, as missing tooth information is a common reason for processing delays.
- • Look at whether your plan covers D0220 under the diagnostic benefit and whether any deductible or waiting period applies.
Common denial or downcoding reasons
- • D0220 was billed on the same date as D0210, and the insurer bundled the individual image into the full series payment.
- • The claim did not include the specific tooth number, causing the insurer to reject it for incomplete information.
- • The plan's annual limit on the number of periapical images was already reached for the benefit year.
- • The image was taken at a follow-up visit too soon after a previous image of the same tooth, triggering a frequency limitation.
What to ask your dentist
- • Which specific tooth is being imaged today, and will that information be clearly noted on the claim submitted to my insurance?
- • If I am also having a full-mouth series taken today, will D0220 be billed separately or is it included in D0210?
- • Is this X-ray being taken to diagnose a problem or to monitor an existing condition, and does that distinction affect my coverage?
- • What is my out-of-pocket cost for D0220 if my insurance denies or limits the claim?
What to check before you pay
- • Confirm the code on the bill matches the code on the EOB.
- • Check whether insurance allowed the charge, denied it, or downcoded it.
- • Compare the provider's billed charge to the negotiated or allowed amount.
- • Ask the office for the clinical reason if the code does not match what you remember receiving.
- • Compare diagnostic codes against frequency limits. Many plans limit exams, bitewings, and panoramic X-rays by time period.
FAQs about D0220
What does a periapical X-ray show that a regular bitewing does not?
A periapical image captures the entire tooth from crown to root tip, including the surrounding bone. Bitewing X-rays focus mainly on the crowns and are better for detecting cavities between teeth.
Can more than one D0220 be billed at the same visit?
Yes, if multiple individual tooth images are taken, each one can be billed separately. However, if many images are taken, your insurer may bundle them and pay as a full-mouth series instead.
Why was my D0220 denied when I also had a full-mouth series?
Many insurers consider individual periapical images to be included in the full-mouth series fee and will not pay for D0220 separately on the same date as D0210.
Is a periapical X-ray the same as a bitewing X-ray?
No. A periapical image shows the full length of a tooth including the root, while a bitewing image shows the upper and lower teeth biting together and is primarily used to detect cavities.
Plain-English disclaimer
This page explains what this code typically means. For official CDT definitions, refer to the ADA. It is not dental, legal, or insurance advice.