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D0140 Dental Code for Limited Oral Evaluation – Problem Focused

What ADA CDT Dental Code is D0140?

The D0140 dental code is used for a limited, problem-focused oral evaluation. This code applies when a patient visits the dentist with a specific oral health concern or problem, such as pain, infection, trauma, or other immediate issues. The examination is focused solely on identifying and diagnosing the specific problem.

What Procedure Does D0140 Refer To?

D0140 involves a focused examination to assess a specific oral health concern. The dentist evaluates the problem area, reviews the patient’s symptoms, and may take radiographs or perform tests as needed to diagnose the issue and recommend further treatment.

Documentation Requirements and Best Practices for D0140

  • Document Patient’s Chief Complaint: Record the primary concern or reason for the visit.
  • Detail Examination Findings: Describe any observations related to the problem area, such as decay, infection, or trauma.
  • Additional Diagnostic Tests: Note any radiographs or tests performed to evaluate the issue.
  • Summary of Diagnosis and Recommendations: Provide a brief summary of the findings and recommended treatment.

How Can I Verify Patient Eligibility and Coverage for D0140?

To verify eligibility and coverage for D0140, contact the patient’s insurance provider. Many plans cover problem-focused evaluations, especially if they are needed for acute issues, but frequency limitations may apply. Checking coverage beforehand ensures the patient is informed of any potential costs.

How Should D0140 Be Submitted on an Insurance Claim, and Should a Site Be Included?

Submit D0140 with a brief description of the specific problem area (e.g., pain in lower left molar). Including these details helps clarify the purpose of the focused evaluation for claim processing.

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D0140 Dental Code Cost

The cost of D0140 varies depending on location and provider but generally ranges from $50 to $100 without insurance. Patients should check with their dental office for exact pricing based on their insurance coverage.

ADA D0140 Guidelines

The ADA recommends D0140 for evaluations that are focused on diagnosing and treating a specific problem, rather than routine or comprehensive check-ups. This code is intended for visits where an immediate issue needs to be assessed and addressed.

What is the Difference Between D0140 and Other Similar Codes?

CodeDescriptionPurpose
D0120Periodic oral evaluation – established patientRoutine check-up for existing patients
D0140Limited oral evaluation – problem focusedExamination focused on a specific oral issue
D0150Comprehensive oral evaluation – new or established patientIn-depth exam for new patients or significant changes
D0160Detailed and extensive oral evaluation – problem focusedComprehensive evaluation for complex problems

Why Was D0140 Specifically Used for My Treatment, and Are There Alternative Treatments with Different Codes and Costs?

D0140 is chosen when the primary purpose of the visit is to address a specific oral health concern. Alternative codes include D0160 for more detailed evaluations if the problem is complex or requires extensive assessment. The choice depends on the complexity of the issue and whether a comprehensive assessment is needed.

How Often Can You Bill D0140?

D0140 is typically billed as needed for acute or specific issues rather than on a routine schedule. Frequency limitations may apply based on the insurance policy, so verifying specific guidelines with the patient’s insurance provider is advisable.

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Picture of Dr. Kirti Parashar

Dr. Kirti Parashar

Dr. Kirti Parashar is a licensed prosthodontist with a Bachelor of Dental Surgery and a Master of Dental Surgery (MDS) in Prosthodontics and Crown & Bridge from Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India. She is a consultant prosthodontist and passionate about using the latest dental technologies and techniques to provide her patients with the best possible care.