In the complex world of dental billing, small missteps can lead to big financial consequences – and bundling CDT diagnostic codes is a common (and costly) error.
While bundling may seem like a shortcut or a way to simplify claim submission, it can actually lead to denied claims, reduced reimbursements, and even compliance risks. Let’s break down what bundling means in the diagnostic category of service, and how to avoid trouble.
What is Bundling?
In billing terms, bundling refers to combining multiple procedures or services under one code – either by accident or in an attempt to streamline the process. While some CDT codes are intentionally “inclusive,” many diagnostic services are billable separately and should not be bundled unless explicitly instructed by the payor to do so.
Common Bundling Mistakes in Diagnostic Codes
- Using D0210 (intraoral – comprehensive series of radiographic images) instead of billing D0220 (intraoral – periapical first radiographic image) and D0230 (intraoral – periapical each additional radiographic image) when a comprehensive series isn’t actually taken.
- Billing D0150 (comprehensive oral evaluation) and assuming radiographs are included, when in fact D0274 (bitewings – four radiographic images) and other radiographic codes should be billed separately when performed on the same date of service.
- Omitting the separate billing of D0330 (panoramic radiographic image) when taken in conjunction with D0210 (intraoral – comprehensive series of radiographic images).
In these cases, bundling undervalues the work performed, limits reimbursement opportunities, and is not in compliance with dental billing best practices.
Why It Matters
Bundling errors often result in:
- Lost revenue – You’re doing more work than you’re billing for.
- Claim denials – Payors may deny claims due to improper coding combinations.
- Compliance risks – Routine undercoding and improper bundling can trigger audits or accusations of fraudulent billing.
- Data distortion – Misreported services skew performance metrics and production reports.
How to Avoid Diagnostic Bundling Errors
1. Know Which Codes are Inclusive
Refer to ADA coding guidelines and payor policies to understand when a code includes other services – and when it doesn’t.
2. Audit Your Claims Regularly
Look for patterns of repeated use of broad codes like D0210 or D0150 without supporting documentation or additional diagnostics billed.
3. Train Your Clinical and Billing Teams
Everyone involved in coding should understand what’s billable and when. Ongoing training is key to staying compliant and maximizing revenue.
4. Document Everything Clearly
Make sure chart notes support the services provided and justify the use of each diagnostic code. Insurance reviewers look for this when validating claims during an audit.
Final Takeaway
In diagnostic coding, precision pays off. By avoiding improper bundling and billing each diagnostic procedure accurately, you protect your practice’s revenue and reduce compliance risk.
Don’t let bundling bite into your bottom line. A few coding adjustments today can lead to better reimbursements—and fewer headaches—tomorrow.
Want help reviewing your diagnostic coding practices or training your team on CDT compliance? Reach out for a custom coding consultation with Practice Booster!
Disclaimer: Insurance administration and dental billing recommendations presented here represent the opinions of the author or our staff and are for informational purposes only. You are responsible for your own use of the CDT Codes, insurance administration, and dental billing. For the latest CDT codes and official interpretations, contact the American Dental Association or visit ADA.org.
