Tag Archives: dental insurance codes

D0150 Comprehensive Evaluation VS. D0180 Comprehensive Perio Evaluation

dental examWe all know about D0150 Comprehensive Evaluation for New Patients. In certain instances, utilizing Code D0180 Comprehensive Periodontal Evaluation might be in your best interest.

This code came out initially for utilization by specialists. Both codes 0150 and 0180 are Comprehensive Oral Evaluations for new and established patients. The difference being 0180 is used exclusively for patients showing signs or symptoms of periodontal disease and with patients with risk factors, such as smoking or diabetes. D0180 requires complete periodontal charting, which includes, but is not necessarily limited to 6 points per tooth, probing, recording recession, furcations, bleeding points, mobility, attachment loss and a periodontal diagnosis. The 0150 may include a periodontal screening and list of any soft tissue anomalies but does not require any recording. That being said, many patients do meet this requirement both as new and/or re-establishing patients.

Most insurance carriers treat the 0180 similarly to the 0150 in that it counts towards one of the two exams that are typically paid per year, although some variations have been noted. Some carriers may reimburse D0180 every 12-24 months or every 3-5 years and some once in a lifetime. Some insurance carriers compensate at a higher rate for the D0180 vs. the 0150. So, this code can be helpful and is being used more and more by general practitioners.

Questions About Dental Codes?

We are happy to help. Call the team at Advanced Practice Management at (952) 921-3360.

Fluoride Code D1206

fluoride on teethMoving forward in 2015, it is best to simplify your fluoride codes. By now, most practices are using fluoride varnishes exclusively for both adults and children. That being the case, it may be beneficial for most offices to use code D1206 Topical Application of Fluoride Varnish as compared to D1208 Topical Application of Fluoride, which does not specify the type of fluoride formulation or technique used for application.

Code D1206 has also dropped restrictions for reporting related to patients with moderate to high caries risk making the code appropriate anytime you apply fluoride varnish. There may be other reasons to use Code 1206 exclusively. Reimbursement may be higher through many insurance plans and, in addition, some contracts may reimburse D1206 for individuals 18 yrs. and older if the patient is at high caries risk. “High Caries Risk” then should be put in the remarks section of the claim form.


If you have questions, call Matt Lahn at Advanced Practice Management. The number is (952) 921-3360. He would be happy to help!