What ADA CDT Dental Code is D0145?
The D0145 dental code represents an oral evaluation specifically for patients under three years of age, including counseling with the primary caregiver. This evaluation focuses on assessing the child’s oral health, educating the caregiver on oral hygiene practices, and discussing prevention strategies to support early childhood dental health.
What Procedure Does D0145 Refer To?
D0145 involves an oral evaluation of a young child’s mouth, teeth, and gums. The dentist or dental hygienist examines the child’s oral structures, checks for any early signs of decay, and discusses proper oral hygiene, diet, and preventive care with the primary caregiver to establish healthy habits.
Documentation Requirements and Best Practices for D0145
- Record Patient’s Age and Oral Health Findings: Note the child’s age and any observations, such as teething, decay, or other concerns.
- Detail Counseling Topics: Document the guidance provided to the caregiver, including hygiene instructions, dietary recommendations, and preventive tips.
- Describe Any Additional Diagnostic Tests: If needed, record details of any tests, such as radiographs.
- Summary of Recommendations: Provide an overview of the advice given to the caregiver for ongoing oral care at home.
How Can I Verify Patient Eligibility and Coverage for D0145?
To verify eligibility and coverage for D0145, contact the patient’s insurance provider. Many plans cover this evaluation as a preventive service for young children, but coverage can vary. Confirming eligibility helps inform the caregiver of any potential out-of-pocket costs.
How Should D0145 Be Submitted on an Insurance Claim, and Should a Site Be Included?
Submit D0145 with the patient’s age and a brief description of the counseling provided. Including this information helps ensure accurate claim processing and supports the code’s application as a pediatric preventive service.
D0145 Dental Code Cost
The cost of D0145 typically ranges from $30 to $80 without insurance, depending on location and provider. Caregivers should consult their dental office for exact pricing based on their insurance plan.
ADA D0145 Guidelines
The ADA recommends D0145 as an early preventive service for young children under three. This evaluation encourages good oral health habits from an early age, promotes caregiver education, and helps identify any issues that may require attention.
What is the Difference Between D0145 and Other Similar Codes?
| Code | Description | Purpose |
|---|---|---|
| D0120 | Periodic oral evaluation – established patient | Routine check-up for existing patients |
| D0140 | Limited oral evaluation – problem focused | Evaluation focused on a specific oral issue |
| D0145 | Oral evaluation for a patient under three years of age and counseling with primary caregiver | Early childhood evaluation with caregiver education |
| D0150 | Comprehensive oral evaluation – new or established patient | In-depth exam for new patients or significant changes |
Why Was D0145 Specifically Used for My Treatment, and Are There Alternative Treatments with Different Codes and Costs?
D0145 is used specifically for patients under three years of age, focusing on early oral health assessment and caregiver counseling. For older children or routine evaluations, codes like D0120 or D0150 may be appropriate. The choice depends on the child’s age and whether caregiver education is a primary goal.
How Often Can You Bill D0145?
D0145 can typically be billed once every six months for young children as part of preventive care. Frequency limitations may vary by insurance provider, so verifying coverage details for regular billing is advisable.
