Insurance Coding Tip

For our general practice doctors, were you aware it is acceptable for you to use code D0180 (Comprehensive periodontal evaluation- new or established patient) in place of D0120 ( periodic oral evaluation- established patient) if you do a full probing and charting once a year? After reading an article in this quarter’s Insurance Solutions Newsletter, I felt the need to pass this tidbit along. The D0180 code is considered appropriate when patients show signs or symptoms of periodontal disease as well as for high risk patients such as smokers and diabetics. While insurances may downgrade to a D0120 (allowing the more accurate D0180 only once every 24 or 36 months) most practitioners ethically prefer to bill out what they actually do as opposed to what insurance covers.