D0210 - Full Mouth X-Rays
Intraoral complete series of images.
- Procedure Code
- D0210
- Category
- Diagnostic
Insurance Verification Benchmarks & Billing Guidelines
Benchmark Policy Source: Delta Dental National / PPO Standard
- Frequency Limitation
- 1 every 36 to 60 months (3 to 5 years) (ROLLING_MONTHS)
- Age Limitation
- Covered for patients with permanent/transitional dentition (typically age 6+).
Required Claim Attachments & Pre-Submission Checklist
- Complete series of diagnostic periapical and bitewing images
- Diagnostic rationale documented in patient record
Bill When (Allowable Clinical Criteria)
- Comprehensive full-mouth radiograph survey consisting of 14-20 films (PAs and bitewings)
Restrictions & Clinical Exclusions
- Do NOT bill on same day as Panoramic radiograph D0330 (they share the same frequency bucket)
- Do NOT bill separate bitewings (D0274) on the same date (bitewings are included in FMX)
Common Claim Denial Codes & Overturn Strategies
| Denial Code | Denial Reason | Appeal & Overturn Strategy |
|---|---|---|
| CO-119 | Frequency limit exceeded or duplicate with Panoramic image D0330 | Verify prior FMX/Panorex dates. PPO plans consider D0210 and D0330 interchangeable under the same 3-5 year limit. |
ICD-10 Justification & Crosswalk Mappings
| ICD-10 Code | Diagnosis Name | Category | Primary Justification | Claim Type | Clinical Scenario |
|---|---|---|---|---|---|
| Z01.20 | Encounter for dental examination and cleaning without abnormal findings | Encounter for other special examination without diagnosis | Yes (Primary) | BOTH | intraoral – comprehensive series of radiographic images indicated for Encounter for dental examination and cleaning without abnormal findings |
| Z01.21 | Encounter for dental examination and cleaning with abnormal findings | Encounter for other special examination without diagnosis | Secondary | BOTH | intraoral – comprehensive series of radiographic images indicated for Encounter for dental examination and cleaning with abnormal findings |
| Z13.84 | Encounter screening for dental disorders | Encounter for screening for other diseases and disorders | Secondary | BOTH | intraoral – comprehensive series of radiographic images indicated for Encounter screening for dental disorders |
| Z86.16 | Personal History of COVID-19 | Personal history of certain other diseases | Secondary | BOTH | intraoral – comprehensive series of radiographic images indicated for Personal History of COVID-19 |
| U07.1 | COVID-19 | Emergency use of U07 | Secondary | BOTH | intraoral – comprehensive series of radiographic images indicated for COVID-19 |