CDT Code for Dental Exam

Dental examination is the close inspection of the teeth and tissues of the mouth using physical assessment, radiographs, and other diagnostic aids. Dental care begins with this assessment, and is followed by diagnosis, planning, implementation, and evaluation.

The purpose of the examination is that it identifies tooth decay and evaluates the health of the gums and other oral tissues. The fit of dentures and bridges (if any) are evaluated. The patient's bite and oral hygiene are also assessed. The dentist then recommends the best treatment options to the patient.

It is important to code the dental examination visit correctly in order to ensure proper dental billing. Currently, there are 6 different exam codes available:

D0120: Periodic oral evaluation, established patient: This examination is done on an established patient to determine changes in dental health since a previous assessment. It includes oral cancer evaluation, periodontal screening and may require interpretation of information. 

D0140: Limited oral evaluation, problem focused: This code should only be used to bill patients with focused problems, not periodic evaluations. So, patients with specific conditions like emergency, infection or something similar are covered for this. Apart from X-rays no other procedure is billed to the insurance.

D0145: Oral evaluation for a patient under three years of age and counseling with primary caregiver.

D0150: Comprehensive oral evaluation- new or established patient. 

D0160:  Used for a problem focused, detailed and extensive oral evaluation.Other term for consultation which is D9310 which is no longer in use by some insurance companies. No other treatment procedures are billed with this.

D0170: This code is appropriate when evaluating a previously existing condition related to trauma, or a follow-up evaluation for continuing issues, but should not be used to report a post-operative visit.