Re-Sub: I work in a pediatric dental office. If a child was initially seen (first visit ever) at our office and is 1 year old and we code out D0145 (Oral Evaluation, pt under 3 yrs), when they return in 6 months for a recall visit- would it be more appropriate to charge out the D0145 again or the D0120 (Periodic Oral Evaluation)? Is the D0145 code only for patient’s under 3 at their initial visit? More specifically- If a child is under age 3 and started seeing us at age 1 year – do we keep billing out the D0145 until they are 3 at every 6 month recall? Thank you for your time. ‘

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  • Re-Sub: I work in a pediatric dental office. If a child was initially seen (first visit ever) at our office and is 1 year old and we code out D0145 (Oral Evaluation, pt under 3 yrs), when they return in 6 months for a recall visit- would it be more appropriate to charge out the D0145 again or the D0120 (Periodic Oral Evaluation)? Is the D0145 code only for patient's under 3 at their initial visit? More specifically- If a child is under age 3 and started seeing us at age 1 year - do we keep billing out the D0145 until they are 3 at every 6 month recall? Thank you for your time. '

Re-Sub: I work in a pediatric dental office. If a child was initially seen (first visit ever) at our office and is 1 year old and we code out D0145 (Oral Evaluation, pt under 3 yrs), when they return in 6 months for a recall visit- would it be more appropriate to charge out the D0145 again or the D0120 (Periodic Oral Evaluation)? Is the D0145 code only for patient’s under 3 at their initial visit? More specifically- If a child is under age 3 and started seeing us at age 1 year – do we keep billing out the D0145 until they are 3 at every 6 month recall? Thank you for your time. ‘

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Asked on April 2, 2014
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It all depends on the carrier. Most carriers will have you bill out the D0145 code until the child is over 3 years of age. However, some want you to bill the initial as D0145 and then the subsequent visits as D0120. You need to check with your utilization review guidelines for your state.

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Answered on April 3, 2014
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