Comprehensive Guide to D0170 Dental Code and Exams

What ADA CDT dental code is D0170?

D0170 is the ADA CDT dental code for a dental exam to follow up an existing problem (i.e. pain, injury) which did not receive prior dental treatment. It is often used as a follow-up code but should not be used as a “post-op” visit after a surgery. The code is officially known as “Re-evaluation – limited problem focused (established patient; not post-operative visit).”

Frequently Asked Questions About D0170 Dental Code

What procedure does D0170 refer to?

This code refers to a re-evaluation of a specific problem after an initial assessment and treatment.

What are the documentation requirements and best practices for D0170?

Documentation should include the initial assessment details, treatment provided, and current findings related to the specific problem.

What are the typical costs, reimbursement rates and guidelines for D0170?

Costs typically range from $50 to $100, depending on the complexity of the issue. Reimbursement varies by provider, and it may be covered as part of follow-up care.

Are there any common errors or pitfalls to avoid with D0170?

Common errors include inadequate documentation of the initial problem and treatment, leading to difficulty in justifying the re-evaluation.

How should D0170 be submitted on an insurance claim, and should a site be included?

Submit with detailed notes on the initial problem, treatment, and findings of the re-evaluation. Site-specific details may be necessary based on the issue.

Is D0170 often used with other codes, and how does it fit into the overall coding system?

Often used with treatment codes specific to the problem being re-evaluated. It helps in tracking the effectiveness of initial treatments and making necessary adjustments.

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

Verify eligibility by contacting the insurance provider to ensure coverage for follow-up evaluations and specific problem-focused assessments.

What are the ethical considerations and common fraud indicators associated with D0170?

Maintain accurate and thorough records of the initial treatment and the findings of the re-evaluation to avoid fraud. Ensure the re-evaluation is genuinely necessary.

What are the key differences between similar codes?

D0170 is for problem-focused re-evaluations, while D0120 and D0150 are for routine or comprehensive exams. Use D0170 for specific issues requiring follow-up.

Why was D0170 specifically used for my treatment, and are there alternative treatments with different codes and costs?

D0170 is used for a targeted follow-up on a specific issue. Alternatives include D0120 for routine check-ups or D0150 for comprehensive exams if broader assessment is needed.

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