Dental Oral Exam Codes List

 

Dental oral exam codes all serve a different purpose.  And lucky us!  Because we have options.  So, let’s take a closer look at our options.   And how exam codes are defined.   It’s easy to get comfortable with just a few codes.  Like the periodic exam and limited evaluation.    However, we miss opportunities when we do that.  And we limit ourselves!

We provide better patient care with an expanded exam protocol.  And we also improve our patient awareness.   I love to add frequency and settings for exams.  It’s so helpful to know who is due for what exam at a glance.  Continuing care settings allow us to track any procedure code we want.  And that includes our exams.

First things first.  Here is a list of the current CDT exam codes we have.  And know that codes frequently change or update.  We can always request a new CDT code consideration.  Or even ask for a change in an existing code. If there is something missing in a code for you, ask.

8 Unique CDT Codes

• D0120 – periodic oral evaluation – existing patient
• D0140 – limited oral evaluation – problem focused
• D0145 – oral evaluation for a patient under 3 years of age and counseling with primary caregiver
• D0150 – comprehensive oral evaluation – new or established patient
• D0160 – detailed and extensive oral evaluation – problem focused, by report
• D0170 – re-evaluation – established patient, limited problem focused, not post operative
• D0171 – re-evaluation, post operative office visit
• D0180 – comprehensive periodontal evaluation – new or existing patient

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Dental Oral Exam Codes Usage

Comprehensive periodontal evaluation (D0180) is for new or existing patients.  If a new patient presents with signs of periodontal disease, this may be a code to consider.  Especially if we identify the patient has risk factors.  A risk factor such as diabetes or patient smokes.  This is an exam performed by the dentist.  And may be an exam we perform once a year for periodontal patients.  Although, it is not a periodontal charting visit.  It is an exam!

Re-evaluation (D0170 and D0171) codes are for established patients.  And these codes are pretty self explanatory.  These are codes we use as a follow-up exam.  One code is post operative one is not.  Post operative is a follow up exam after a dental surgery.

Detailed and extensive oral evaluations (D0160)  require a narrative.  And this code is more extensive than a limited or periodic exam.  This exam may involve both past dental issues as well as new dental issues.

Comprehensive oral evaluation (D0150) is for new and existing patients.  All our new dental patients receive this level of care.  However, what about our existing patients?  We can certainly complete a more thorough exam for our existing patients every 3-5 years.  And this exam in conjunction with a new series of full x-rays is beneficial.

 

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And The Final Three!

Oral evaluation for a patient under 3 years of age (D0145) is self-explanatory.  And this procedure code includes consultation costs of talking with the primary caregiver.  It makes sense that a separate code exists for this particular need.

A limited oral evaluation (D0140) is a problem focused exam.  A patient with a toothache or broken tooth is an example of such.  Our emergency dental patients fall into this category.  And this might be a new or an existing patient.

Finally, our periodic oral exam (D0120) for existing patients.  This exam often accompanies a hygiene visit.  Although it can be a separate visit as well.  However, we might consider a more detailed exam code if this is the case.  And this is one of the codes I would set a continuing care frequency for.

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Dental Oral Exam Codes With Continuing Care

Continuing care settings are fabulous!  I love to see what my patient is due for on their demographic screen.  Dental exams are a critical piece of patient care.  Is my patient due for a periodic exam?  When was their last periodic exam?  And are they due for a full comprehensive oral evaluation?  All these factors contribute to my dentist’s restorative schedule too.

Perhaps you want to alternate comprehensive periodontal exams with periodic exams for perio patients.   Or for those with high risk factors.  And maybe you want to schedule a full comprehensive exam for existing patients every 5 years?  Maybe you already do these things.  Perhaps it’s time to add a frequency and continuing care setting?

I highly recommend a written policy for dental exams.  Make sure the team knows the policy and understands the differences between each exam code.   And try not to base your use of dental exams on insurance benefits.  Remember, insurance benefits are meant to be just that.  A benefit that helps a patient with dental costs.  It is not meant to be a guide on how to provide dental care.  And our patients may need our help understanding this.

 

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Fees For Exams

Naturally, fees also vary from one exam code to another.  And each fee is set based on the complexity of the exam.  It pays to know the fees for each exam code as well.  Patients often ask the cost of appointments as they schedule. Try to update fee schedules each year and include exams.

As a dental team member, ask your doc about your exam protocol.  It’s a helpful conversation to have.  If there is no protocol, ask for one.  It will help you as you talk with patients.    And as a dentist or practice manager, talk with the team.  Prepare the written protocol and policy.  And then distribute and discuss the office exam policy!  Please let me know if I can be of any help.  I’m just an email away.