How often can D0277 be billed to insurance?

Frequency limitations vary by insurance provider, but generally, D0277 can be billed once every 12-24 months unless additional medical necessity is documented.

Can D0277 be used as part of a full mouth series?

No, D0277 is not considered part of a full mouth series. It specifically covers vertical bitewing images and should be billed separately.

Are there any specific patient conditions that necessitate the use of D0277?

Yes, patients with periodontal disease, extensive restorations, or those requiring detailed interproximal evaluation may benefit from vertical bitewings.

Is pre-authorization required for D0277?

Pre-authorization requirements vary by insurance provider, so it's important to check with the patient's insurance for specific guidelines.

D0277

Vertical Bitewings - CDT Code Guide

Diagnostic/Image Capture with Interpretation

Overview

CDT code D0277 refers to the capture of vertical bitewing radiographs, specifically involving 7 to 8 images. This procedure is crucial for providing detailed views of the interproximal areas of the teeth, helping in the detection of caries, periodontal bone loss, and other dental conditions. Unlike a full mouth series, this set of images focuses on specific areas, offering a comprehensive view of the posterior teeth and supporting structures. Dental professionals often use this code when a more detailed examination is needed beyond the standard horizontal bitewings, especially in patients with periodontal disease or extensive restorations.

When to Use This Code

When assessing periodontal bone levels in patients with periodontal disease.
For detailed evaluation of interproximal caries in patients with extensive restorations.
In cases where horizontal bitewings do not provide sufficient diagnostic information.
For patients with a history of periodontal surgery requiring detailed monitoring.
When monitoring the progression of periodontal disease over time.

Documentation Requirements

Document the clinical necessity for vertical bitewings over horizontal bitewings.
Include detailed notes on the findings from the radiographic images.
Ensure images are stored and labeled correctly in the patient's record.
Record the number of images taken and their specific focus areas.
Justify the frequency of the procedure if performed more than once a year.

Billing Considerations

When billing for D0277, it's important to note that insurance carriers may have frequency limitations, often covering this procedure once every 12-24 months unless additional justification is provided. Common modifiers may include those indicating the necessity for additional radiographs due to specific clinical findings. Always verify with the patient's insurance provider for coverage specifics and pre-authorization requirements.

Related CDT Codes

D0210 D0330 D0272 D0274 D0220

Frequently Asked Questions

Vertical bitewings provide a more detailed view of the periodontal bone levels, making them ideal for patients with periodontal disease, whereas horizontal bitewings are typically used for general caries detection.

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