I am new to dental coding and having a hard time deciphering exam code D0150 from D0140 for new patients. To provide an example, I had a patient who came to the oral surgeon on referral from her regular dentist to have her wisdom teeth removed. The oral surgeon notes in the history that her wisdom teeth are impacted but asymptomatic, that she has no allergies, her family history is non-contributory, and she’s not a smoker. He then takes a panorex and looks at the gums and notes the impacted wisdom teeth and the absence of any malocclusion. He is not including a total perio chart in the record (though he’s also indicated the presence of a malpositioned canine tooth). He doesn’t mention the hard/soft palates or any soft tissue anomalies (not referencing looking at the tongue or the mucosa). So while he is looking around at a lot of structures in the mouth, not just at the wisdom teeth, he doesn’t appear to me to be documenting the full extent of what is described by CDT code D0150, but at the same time, D0140 for a problem-focused exam seems like less than the work he is doing. In this particular example, would you recommend D0150 or D0140?

I am new to dental coding and having a hard time deciphering exam code D0150 from D0140 for new patients. To provide an example, I had a patient who came to the oral surgeon on referral from her regular dentist to have her wisdom teeth removed. The oral surgeon notes in the history that her wisdom teeth are impacted but asymptomatic, that she has no allergies, her family history is non-contributory, and she’s not a smoker. He then takes a panorex and looks at the gums and notes the impacted wisdom teeth and the absence of any malocclusion. He is not including a total perio chart in the record (though he’s also indicated the presence of a malpositioned canine tooth). He doesn’t mention the hard/soft palates or any soft tissue anomalies (not referencing looking at the tongue or the mucosa). So while he is looking around at a lot of structures in the mouth, not just at the wisdom teeth, he doesn’t appear to me to be documenting the full extent of what is described by CDT code D0150, but at the same time, D0140 for a problem-focused exam seems like less than the work he is doing. In this particular example, would you recommend D0150 or D0140?

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Asked on January 3, 2017 8:45 pm
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D0140 is for a patient being seen for a specific problem minimal documentation is required. Why the patient was there or Chief Complaint and proposed treatment.
D0150 is for a first time patient and must meet the following criteria oral cancer screening, evaluation and recording of patients dental and medical history and overall general health assessment, dental carries present, missing or unerupted teeth, restorations and any existing prosthesis, occlusal relationships and any periodontal issues. This code should be used in general practice for a first time patient evaluation.

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Answered on January 4, 2017 8:45 pm
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