Is D0120 covered by most dental insurance plans?

Yes, D0120 is generally covered by most dental insurance plans as part of routine preventive care, but coverage can vary.

Can D0120 be billed on the same day as other diagnostic procedures?

Yes, D0120 can be billed alongside other diagnostic procedures, but each procedure must be documented separately.

What is the difference between D0120 and D0150?

D0120 is for periodic evaluations of established patients, while D0150 is for comprehensive evaluations, typically for new patients or those not seen for a long time.

Does D0120 include a periodontal screening?

Yes, a periodontal screening is included in D0120 when indicated, based on the patient's oral health status.

D0120

Periodic Oral Evaluation - CDT Code Guide

Diagnostic/Clinical Oral Evaluations

Overview

The D0120 code refers to a periodic oral evaluation for established patients, crucial for monitoring changes in a patient's dental and medical health status since their last comprehensive or periodic evaluation. This procedure includes an oral cancer evaluation and periodontal screening when necessary. It may also involve interpreting data from additional diagnostic procedures. The findings are then discussed with the patient to ensure they are informed about their oral health. This evaluation is an essential component of preventive dental care, allowing dentists to detect potential issues early and maintain optimal oral health for their patients.

When to Use This Code

During a routine check-up for an established patient to update their dental health status.
When a patient returns for a follow-up after a previous comprehensive evaluation.
To monitor changes in periodontal health in patients with a history of gum disease.
As part of a regular oral cancer screening process for patients with risk factors.
To assess the need for further diagnostic procedures based on initial findings.

Documentation Requirements

Patient's dental and medical history since the last evaluation.
Details of the oral cancer evaluation performed.
Results of the periodontal screening, if conducted.
Interpretation of any additional diagnostic procedures undertaken.
Discussion notes with the patient regarding findings and recommendations.

Billing Considerations

The D0120 code is typically billed once every six months for established patients. It is important to check with the patient's insurance provider for specific coverage details and frequency limitations. Common modifiers may include those indicating the patient's status or special circumstances. Accurate documentation is crucial to avoid claim denials.

Related CDT Codes

D0150 D0180 D0191 D0210 D1110

Frequently Asked Questions

D0120 can typically be billed every six months, but it's important to verify with the patient's insurance plan for specific frequency limitations.

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