D0272Bitewings, Two Radiographic Images

What This Code Covers

D0272 covers two bitewing radiographic images taken during a single visit. These two x-rays typically capture the right and left posterior teeth, showing the crowns and crestal bone of premolars and molars on each side. This code is most commonly used for pediatric patients, adolescents, or adults with limited posterior dentition where a full four-bitewing series is not necessary. Two bitewings give the dentist a bilateral view of interproximal areas without the additional images required for a standard adult set.

Billing Guide

Bill this code when:

• Exactly two bitewing images are taken during the visit
• The patient is a child or adolescent whose dentition does not require four bitewings
• The patient is an adult with limited posterior teeth (for example, missing most premolars or molars on both sides)
• The clinical record documents why two images were sufficient for diagnostic purposes

Do not bill this code when:

• Only one bitewing was taken. Use D0270 instead
• Four bitewings were taken. Use D0274 instead
• The bitewing images are part of a full mouth series (D0210). Do not unbundle individual images
• The images taken are periapical radiographs, not bitewings. Use D0220 or D0230 for periapicals
• Two separate D0270 codes are billed instead of one D0272. Always use the grouped code

Insurance and Denial Prevention

Key Payer Rules:

• Most plans cover bitewings once every 6 to 12 months. The number of images allowed (two vs. four) often depends on the patient's age
• Many payers automatically approve D0272 for patients under age 12 and D0274 for patients 12 and older. Know your payer's age cutoffs
• Delta Dental and similar plans may downgrade D0274 to D0272 for pediatric patients if four bitewings are submitted for a young child
• Medicaid plans often have strict age-based guidelines. Some only allow two bitewings for children under a certain age, regardless of clinical need

Common Denials and How to Respond:

• Frequency exceeded - Check the last bitewing date on the patient's record. If the interval is shorter than the plan allows, submit a narrative explaining the clinical reason (such as high caries risk or monitoring active treatment).
• Age or dentition mismatch - If a payer denies D0272 for an adult, include a note explaining the patient's limited posterior dentition. Attach the radiograph showing the reduced number of teeth if possible.
• Downcode from D0274 - If the payer downcodes four bitewings to two, review whether the patient's age or plan terms justify the downcode. If four were clinically necessary for an older child or teen, appeal with the clinical rationale and documentation of mixed or full permanent dentition.