D0270 Dental Code: Single Bitewing X-Ray Billing Guide

What D0270 covers

D0270 reports one bitewing X-ray, billed as a single image. A bitewing shows the crowns of the upper and lower teeth in one view, with the contact areas between adjacent teeth lined up so the dentist can read interproximal decay and check bone levels at the crest.

The defining fact is the count: one image. The whole bitewing family is coded by how many images are taken in the session, not by which teeth they show or why they were taken.

It does not cover:

• Two, three, or four bitewing images. Use D0272, D0273, or D0274 (see the family below).
• A vertical bitewing set of seven to eight images. That is D0277.
• A periapical image, which shows the full length of the tooth down to the root apex. The first periapical is D0220 and each additional one is D0230.
• A full intraoral complete series. That is D0210.

When to bill D0270

Bill D0270 when the office captures exactly one bitewing image. A lone bitewing is most common for a focused recall on one quadrant, a follow-up on a single area of concern, or a child with a limited posterior contact to check.

If the session produces more than one bitewing, move up the family to the code that matches the count.

How D0270 fits the rest of the bitewing family

Image count is the only axis that separates the codes:

• D0270 is one bitewing image.
• D0272 is two.
• D0273 is three.
• D0274 is four.
• D0277 is a vertical bitewing series of seven to eight images, used when the question is alveolar bone level rather than interproximal decay.

There is no rule to bill D0270 per image and let the carrier total them. The set codes exist so a multi-image set bills as one line.

Bitewings versus periapicals versus the full series

Keeping these image types separate prevents most diagnostic-imaging adjustments:

• A bitewing (D0270 through D0277) is an interproximal view. It captures the crowns of the back teeth and the bone crest, not the root tips, and is used to find decay between teeth and read early bone loss.
• A periapical (D0220 first, D0230 each additional) captures the entire tooth, crown through root apex, plus the surrounding bone. It is used for questions about the root and the area around it: abscess, fracture, retained root, pre-extraction assessment.
• A panoramic (D0330) is a single extraoral image of both arches, the jaws, and the sinuses.
• A complete series (D0210) is a comprehensive set of intraoral images meant to show the whole mouth. CDT 2023 removed the old 14 to 22 image wording, so the dentist decides the number and type of images.

A panoramic plus a few bitewings is not a complete series. Reporting that combination as D0210 is a known error and a clear reason for a carrier to adjust the claim.

Frequency limits carriers apply

Bitewings are among the most frequency-restricted images. Most plans allow them on a set interval, commonly once or twice per benefit year, and the allowance almost always pools the whole bitewing family rather than tracking D0270 on its own. A single bitewing taken inside the allowance pays; one taken outside it denies on frequency.

The interval, whether it resets on a calendar year or a rolling twelve months, and whether children get a different allowance are all set by the individual plan. Confirm them during verification, not at the chair.

Documentation that supports the claim

A routine single bitewing rarely needs a narrative. When it does, the supporting facts are:

• The tooth or quadrant imaged and the clinical reason (recall, focused follow-up, decay check).
• The date of the prior bitewings, so a frequency question can be answered without a second request.
• The image itself, attached when the carrier asks for it or when the visit is outside the normal recall pattern.

Most bitewing denials are frequency denials, so keep each patient’s last bitewing date where the billing team can see it.