Summary & Overview
CDT D0230: Intraoral Periapical Each Additional Radiographic Image
CDT code D0230 represents an additional intraoral periapical radiographic image used in dental care when more than one periapical film is required for diagnosis or treatment planning. Nationally, periapical imaging is a routine diagnostic tool in general dentistry and specialty services such as endodontics; accurate coding of additional images affects claim adjudication, patient cost sharing, and encounter documentation. Key national payers covered in this review include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find a concise explanation of the code’s clinical context, how it pairs with the first periapical image code, and common scenarios that prompt additional periapical exposures. The publication outlines payer coverage considerations, common modifiers reported with additional radiographic services, and associated diagnostic ICD-10 codes used to support medical necessity. Related dental imaging codes and service alternatives are identified for coding clarity. If specific service-line metadata or payer-specific fee schedules are needed, note that detailed reimbursement data is not present in the input. This summary is intended to orient clinicians, billing staff, and policy analysts to the clinical purpose and billing context of CDT code D0230 at a national level.
Billing Code Overview
CDT code D0230 denotes Intraoral - periapical each additional radiographic image. This service is used in dentistry to capture an additional periapical radiographic image when more than one image is required beyond the first periapical film. The service type is Dentistry, and the typical site of service is a Dental Office (POS 11).
Clinical & Coding Specifications
Clinical Context
A 35-year-old patient presents to a dental office (POS 11) with localized tooth pain and suspected periapical pathology following a recent history of deep caries. The dentist performs an initial periapical radiograph (CDT code D0220) of the symptomatic tooth and obtains one or more additional periapical images to fully visualize the root apices and surrounding bone. Images are obtained intraorally, each additional radiographic image billed as CDT code D0230. The clinical workflow includes patient evaluation, selection of appropriate intraoral receptors, exposure of the first periapical image, acquisition of additional periapical images as needed for diagnosis or treatment planning (e.g., endodontic evaluation), and documentation of the number and reason for additional images in the chart.
Coding Specifications
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Common Modifiers
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52(Reduced Services): Used when a normally described service is partially reduced or eliminated at the physicians discretion. Apply when an additional periapical image is performed with limited technique or scope compared to the full service. -
76(Repeat Procedure by Same Physician): Used when the same service is repeated subsequent to the original procedure by the same practitioner. Apply when an additional periapical image is retaken during the same encounter because the first additional image was inadequate. -
Associated Provider Taxonomies
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122300000X: General Practice Dentist — represents dentists providing general dental care. -
1223D0001X: Dental Public Health — represents providers focused on community oral health and prevention programs. -
1223E0200X: Endodontics — represents specialists in diagnosis and treatment of pulpal and periapical disease.
Related Codes
| Code | Description |
|---|---|
D0220 | Intraoral - periapical first radiographic image |
D0272 | Bitewings - two radiographic images |
D0330 | Panoramic radiographic image |
D0210 | Intraoral - complete series of radiographic images |
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D0220: The first periapical image in a series;CDT code D0230is billed for each additional periapical image afterD0220. These two codes are commonly used together when multiple periapical images are required. -
D0272: Bitewing images are alternative intraoral views primarily for interproximal caries and less commonly used for periapical assessment. Bitewings may be used in the same visit for complementary diagnostic information but are a different view thanD0230. -
D0330: A panoramic radiograph provides a broad extraoral overview and can be an alternative or adjunct to multiple periapical images; it may be used when a complete survey of both jaws is indicated instead of multipleD0230images. -
D0210: A complete intraoral series covers multiple periapical and bitewing views; when a full series (D0210) is performed, individual periapical additional images (D0230) are typically not billed separately as they are included in the series.D0230is commonly used when isolated additional periapical images are required rather than a full series.
Related Diagnoses
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K08.89— Other specified disorders of teeth and supporting structures- Clinical relevance: May include structural tooth conditions or supporting tissue abnormalities that prompt focused periapical imaging to evaluate local anatomy or pathology.
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K04.7— Periapical abscess without sinus- Clinical relevance: Periapical abscess often requires periapical radiographs to identify radiolucency at the root apex and guide endodontic or surgical management; additional periapical images can help localize the lesion.
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K04.4— Acute apical periodontitis of pulpal origin- Clinical relevance: Acute apical periodontitis commonly necessitates periapical imaging to assess inflammatory changes at the apex and to plan endodontic treatment; extra images may be needed for multi-rooted teeth.
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K03.6— Deposits [accretions] on teeth- Clinical relevance: Localized deposits or calcifications can obscure anatomy; additional periapical views may be taken to clarify the relationship to the root or surrounding structures.
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K02.9— Dental caries, unspecified- Clinical relevance: Deep caries approaching the pulp may produce periapical changes; additional periapical images assist in assessing pulpal involvement and apical status.
National Reimbursement Benchmarks
National commercial mean rates for CDT code D0230 are substantially higher than Medicare when compared to BUCA (the average commercial benchmark). BUCA’s mean rate is $10.67, which lies between lower-cost payers such as Aetna ($6.96) and Cigna Health ($7.79) and higher-cost payers such as Blue Cross Blue Shield ($16.04) and UnitedHealthcare ($15.42). Medicare mean rate data is not available in the input, so a direct numeric comparison to Medicare cannot be provided.
Rate dispersion (P75 minus P25) varies across payers. Blue Cross Blue Shield shows a wide spread (6.5), UnitedHealthcare also shows a wide spread (3.75), while Aetna and Cigna Health are tighter (Aetna spread 4.8; Cigna Health spread 4). BUCA’s interquartile spread is 7.0, indicating broader variation within the average commercial benchmark group. The table and chart below present the full breakdown.
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