Billing Code Overview

CDT code D0220 represents an intraoral periapical radiographic image of the first tooth or region captured. This procedure is a standard component of dental diagnostic imaging used to evaluate the apex and surrounding structures of a specific tooth. The service is typically performed in an office setting (POS 11) and produces a single periapical image intended to identify pathology such as periapical lesions, root morphology, and localized dental conditions.

Clinical Context

A patient presents to a dental office (POS 11) with localized tooth pain or signs of periapical pathology. The dentist performs an intraoral clinical examination noting focal tenderness to percussion or suspected apical pathology on a specific tooth. To evaluate the tooth root and periapical tissues, the dentist obtains an intraoral periapical radiograph: CDT code D0220 (intraoral - periapical first radiographic image). The image is captured using standard intraoral periapical techniques, processed or digitized, and reviewed by the treating dentist to inform diagnosis and treatment planning (for example, root canal therapy, restoration, or monitoring). If additional periapical images are required for adjacent teeth or different angulations, associated code D0230 is used for each additional image.

Coding Specifications

• Common Modifiers:

• 52 - Reduced Services: Use when the procedure is partially reduced or eliminated at the dentist's discretion. This modifier indicates the service was performed in a reduced manner relative to the full procedure description.

• 76 - Repeat Procedure by Same Dentist: Use when the same dentist repeats the identical procedure subsequent to the original service, typically because the initial image was uninterpretable or a repeat was clinically necessary.

• Associated Provider Taxonomies:

• 122300000X - Dentist: Represents licensed dentists providing diagnostic and operative dental services, including intraoral radiographic imaging.

Related Codes

• D0230 - Intraoral - periapical each additional radiographic image

  Relation: Billed when more than one periapical image is needed in the same visit; D0220 is the first image and D0230 is used for each additional image.

• D0210 - Intraoral - complete series of radiographic images

  Relation: A complete series (D0210) covers multiple intraoral images of the entire dentition; D0220 may be used instead when only a single periapical image is required rather than a full series.

• D0240 - Intraoral - occlusal radiographic image

  Relation: An occlusal image (D0240) visualizes larger cross-sectional areas or arch anatomy; it may be used in conjunction with D0220 when broader visualization of anatomy is needed or as an alternative projection.

Related Diagnoses

• K08.89 - Other specified disorders of teeth and supporting structures

  Relevance: Broad category capturing non-specified structural or supporting tooth disorders that may prompt a periapical radiograph to evaluate underlying causes.

• K04.7 - Periapical abscess without sinus

  Relevance: Periapical abscess can present with localized pain and radiographic periapical radiolucency; D0220 is used to obtain the initial periapical image for diagnosis.

• K04.5 - Chronic apical periodontitis

  Relevance: Chronic apical inflammatory changes at the tooth apex are assessed with periapical radiographs to determine extent and plan endodontic treatment or monitoring.

• K03.6 - Deposits [accretions] on teeth

  Relevance: Localized deposits may be associated with periodontal or localized tooth issues; a periapical image can assist in evaluating adjacent supporting structures.

• K02.9 - Dental caries, unspecified

  Relevance: Deep caries approaching the pulp or involving periapical tissues may necessitate a periapical radiograph to assess periapical involvement.