D0274 — Four Bitewing Radiographs
D0274 is the standard set of four bitewing images taken at recall visits to check for decay between the back teeth.
Four bitewings is the default recall imaging for an adult with a full set of back teeth: two on each side, one covering the premolars and one the molars. Between them they open up every contact point in the back of the mouth, which is where almost all adult decay starts and where none of it is visible to the eye.
This is the single most frequently reported imaging code in general dentistry. It appears on most recall bills once a year, usually alongside D0120 and a cleaning.
Why four, and not two
Two bitewings cover the premolar and first molar region; they miss the contacts behind that. For a patient with second molars and wisdom teeth, a two-image set leaves the most decay-prone contacts in the mouth unimaged. Four images — premolar and molar views on both sides — cover everything from the canine back.
Patients with fewer back teeth need fewer images, which is why D0272 (two) and D0273 (three) exist. Offices should report the number actually taken, and plans check that the number is plausible for the teeth present.
What the dentist is comparing
Recall bitewings are read as a series over time, not in isolation. A small shadow at a contact point that has not changed in four years is watched; the same shadow that has clearly grown since last year is treated. This is why keeping your imaging with one practice — or transferring copies when you move — genuinely affects the treatment you are offered.
The bone crest is the other thing being tracked. Bitewings are the best two-dimensional record of early bone loss between teeth, and a comparison over several years is often what triggers a periodontal evaluation.
Frequency limits and the six-month patient
Most plans allow one set of bitewings every twelve months. Some allow them every six months for patients with documented high decay risk, but this usually requires the office to note the risk factors. If your practice images you every six months and your plan pays annually, expect to pay for the alternate set.
A frequency denial on bitewings is almost always a date arithmetic issue. Plans operating on a strict twelve-month rule will reject a set taken at eleven months and pay the same claim resubmitted a few weeks later.
Questions about D0274
What are four bitewing X-rays for?
They open up every contact point between the back teeth on both sides, which is where most adult decay begins and where it cannot be seen or felt.
How often does insurance cover D0274?
Most plans allow one set every twelve months. Some allow every six months for documented high-risk patients.
Do bitewings show abscesses?
No. They stop at the bone crest. An abscess at the root tip needs a periapical image or a cone beam scan.
Why was my bitewing claim denied?
Almost always frequency — the previous set was taken less than twelve months earlier. Checking the exact prior date usually resolves it.
Also known as: four bitewings, bitewing set, recall X-rays, cavity detection.