Understanding D0120 Dental Code and Exams

What ADA CDT dental code is D0120?

D0120 is the ADA CDT dental code for a periodic dental exam for an established patient. This is often a routine recall exam. The code is officially known as “periodic oral evaluation – established patient.”

Frequently Asked Questions About D0120 Dental Code

What procedure does D0120 refer to?

This code refers to a periodic oral evaluation for an established patient, typically performed every six months.

What are the documentation requirements and best practices for D0120?

Documentation should include detailed notes on the patient’s dental and medical history, charting of current conditions, and any changes since the last visit.

What are the typical costs, reimbursement rates and guidelines for D0120?

Typical costs range from $50 to $100, with reimbursement rates varying by insurance provider. Coverage is usually routine under preventive care benefits.

Are there any common errors or pitfalls to avoid with D0120?

Common errors include failing to update patient history and not documenting changes accurately, which can lead to claim denials.

How should D0120 be submitted on an insurance claim, and should a site be included?

Submit D0120 with the patient’s dental chart, including detailed notes on oral conditions. No site-specific details are usually required.

Is D0120 often used with other codes, and how does it fit into the overall coding system?

This code is often used with codes for preventive care procedures like prophylaxis (D1110) and fluoride treatments (D1208). It helps in regular monitoring of oral health.

How can I verify patient eligibility and coverage for this procedure?

Verify eligibility by contacting the patient’s insurance provider or using an online verification system to confirm preventive care coverage.

What are the ethical considerations and common fraud indicators associated with D0120?

Ensure all information is accurate and up-to-date to avoid fraudulent claims. Regularly update patient records and maintain thorough documentation.

What are the key differences between similar codes?

D0120 is for periodic evaluations, whereas D0150 is for comprehensive evaluations. Use D0120 for routine check-ups and D0150 for initial or more extensive exams.

Why was D0120 specifically used for my treatment, and are there alternative treatments with different codes and costs?

D0120 is used for routine check-ups to monitor oral health. Alternative procedures include D0150 for a more comprehensive exam, which may be necessary for new patients.

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