CDT Codes for Dental Exams and the Importance of Insurance Verification

Hi this is Amber Darst, Solutions Manager here at Managed Outsource Solutions and I’ll be discussing the importance of understanding the various CDT codes for dental exams and verifying the insurance plan frequencies for each of these codes.

00:19 CDT dental exam codes

Coding dental exams correctly on insurance claims is crucial for proper dental billing. There are several different dental exam codes and knowing what each of them mean and when to use them is necessary for proper billing and reimbursement. Here are a few of the most commonly used codes.

• D0150 is a comprehensive oral evaluation and this is for new or established patients.
• D0180 is a comprehensive periodontal evaluation and this is also for new or established patients.
• D0120 is a periodic oral exam. This is for established patients and this code is most commonly used when coming in for regular cleanings and checkups.
• D0140 a limited oral evaluation, problem focused and this code is typically used for emergency visits.

01:24 Importance of Insurance Verification

Another important thing to keep in mind is that often times these codes will share a frequency. What that means is if the patient has been recently seen another dental office or has even come into your office say on like an emergency visit and had a limited exam completed, their insurance may not pay towards another exam within the next so many days or even months according to their plans, rules and regulations. The best way to ensure that you’ll get paid properly for the services that you provide is to always complete a thorough insurance verification for each patient prior to their visit. This will give you the information to know whether the patient needs to pay upfront for the exam or when they would be next eligible for another exam through their insurance.

02:15 Hire an Experienced Dental Billing Company

Hiring an experienced dental billing company can get this very tedious and time-consuming task off your hands and allows you more time to focus on what’s most important – patient care.

And that’s all. Thanks for listening in.