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D0145 Dental Code for Oral Evaluation for a Patient Under Three Years of Age and Counseling with Primary Caregiver

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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 childโ€™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 childโ€™s mouth, teeth, and gums. The dentist or dental hygienist examines the childโ€™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 Patientโ€™s Age and Oral Health Findings: Note the childโ€™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 patientโ€™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 patientโ€™s age and a brief description of the counseling provided. Including this information helps ensure accurate claim processing and supports the codeโ€™s application as a pediatric preventive service.

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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?

CodeDescriptionPurpose
D0120Periodic oral evaluation โ€“ established patientRoutine check-up for existing patients
D0140Limited oral evaluation โ€“ problem focusedEvaluation focused on a specific oral issue
D0145Oral evaluation for a patient under three years of age and counseling with primary caregiverEarly childhood evaluation with caregiver education
D0150Comprehensive oral evaluation โ€“ new or established patientIn-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 childโ€™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.

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