Dental Code Definition

From maintaining oral hygiene to distinct dental procedures, each process itself requires an individual to often visit a dentist for a consultation. The nature of the visit varies every time from just an oral examination to maybe getting a detailed surgery and this is where the dental codes play a significant role. After every checkup, you are required to report a dental office visit code as established by the American Dental Association (ASA) for efficient dental billing and reimbursement. Hence, it is imperative to have a clear idea of what the purpose of each dental code such as d0140 is.

D0140 Dental Code

Dental code D0140 is a problem-focused procedure code that involves ‘Limited Oral Evaluation’. This refers to a visit that will solely focus on evaluating a specific oral health complaint about that specific area of the problem.

It includes:

  • Visual evaluation by the dentist
  • Any sort of X-rays if required

Hence, it helps to prevent any possible diseases/infections through a proper diagnosis that can be later acted upon. Its main purpose is thus, preventive care. Depending on the diagnosis, you may be advised to undergo treatment immediately or book a follow-up appointment for the treatment needed. However, the costs of the treatment will not come under the dental code d0140.

When to use the D0140 Dental Code?

This code is recommended to be used only for focused dental problems or dental emergencies and not periodic evaluations. The issues relevant to this code include:

  • Traumatic injury
  • Acute infection
  • Evaluation of tooth replacement such as implant placement
  • Oral lesion or wisdom tooth eruption
  • A specific problem where a limited evaluation of a certain area such as an oral cavity is needed
  • Any other dental emergency

Limitations of D0140 Dental Code

Though it may differ for every company, however, most dental plans only offer ‘One evaluation per every six months or in other words two evaluations in a year in total. Hence, it is very important to wisely use CPT d0140 only in the case of specific emergencies.

Moreover, any diagnostic radiographic images for the evaluation need to be taken on the same day of the visit to be considered eligible for reimbursement. Additionally, they need to be submitted along with the D0140 claim to be included in the service provided. If the images have been submitted previously or were taken on any other day, then they will not be considered by the dental insurance companies.

Billing Procedure for a D0140

Firstly, you need to indicate your status whether you are a new or an established patient. A new patient would be the case if you haven’t visited the dentist in the past six months and established refers to if you have visited the dentist in the past six months.

When billing you are required to fill in the patient’s name, date of service, dentist’s name, and the procedural dentist code which in this case would be d0140.

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Misuse of D0140 Dental Code

We hope that the d0140 dental code description that has been provided by us so far was useful, and informative, and has cleared almost all the queries you may have had. However, there is one more very important thing that you need to remember to make sure you do not exceed the code limit and end up paying through your own pockets.

According to annual statistics, the D0140 dental code is overly reported. This is because often the patients claim this code for treatments done for easing oral discomfort and pain. However, it is to note that the ACA has provided another dental code for treatments related to pain which is ‘D9110’.

D9110 is used for emergency visits that cater to providing prescriptions or providing a minor non-definitive procedure to alleviate discomfort, pain, or sensitivity on an emergency visit.

D0140 is a stand-alone code and may always be reported in conjunction with D9110. However, many companies do not reimburse D0140 in conjunction with D9110 if performed on the same service date. Hence, remember that D9110 is the palliative dental code.

Unless a limited oral evaluation of a specific area for preventive purposes has not occurred, DO NOT use d0140. This will save you your ‘one evaluation per 6 months’ privilege for a worse emergency situation.

Conclusion

D0140 is vital for dental emergencies. From traumatic injuries to oral infections, it provides an opportunity for you to quickly visit a dentist and get the problem thoroughly diagnosed with suggestions of possible treatments in case of a serious problem. Moreover, if you get lucky enough to not face any immediate emergencies then you can always use it by the end of every six months for a comprehensive oral evaluation just in case. This will help you maintain your oral hygiene by diagnosing and possibly preventing the development of any possible diseases.