D0120 is for periodic oral evaluations on established patients. This is the routine recall exam your patients get every 6 months. It includes an assessment of dental and periodontal health, an update to the medical history, and clinical findings documentation. Use this code for patients who have already had a comprehensive evaluation (D0150) and are returning for ongoing care.
D0120 is for periodic oral evaluations on established patients. This is the routine recall exam your patients get every 6 months. It includes an assessment of dental and periodontal health, an update to the medical history, and clinical findings documentation. Use this code for patients who have already had a comprehensive evaluation (D0150) and are returning for ongoing care.
Do NOT use D0120 for: New patients who have never been seen at your practice (use D0150). Patients presenting with a specific problem or emergency (use D0140). Patients with periodontal disease requiring a periodontal evaluation (use D0180).
Click any code to see the difference.
Periodic eval for established patients returning for routine recall. Shorter, focused on changes since last visit.
Comprehensive eval for new patients or patients who haven't been seen in 3+ years. Thorough examination of all oral structures.
Most plans cover D0120 twice per calendar year or once every 6 months. If the patient was seen 5 months ago, the claim gets denied. Check the patient's last D0120 date before scheduling. Some plans count by calendar year, others by rolling months. Know which your patient's plan uses.
You cannot bill D0120 and D0150 on the same date of service. They're mutually exclusive evaluation codes. If a new patient comes in, it's D0150. If an established patient returns for recall, it's D0120. Billing both triggers an automatic denial.
Clinical notes must document what was evaluated. A note that just says "periodic exam" isn't sufficient. Document findings: caries check, soft tissue exam, occlusion assessment, periodontal screening, review of medical history changes.
Document all findings: caries status, soft tissue assessment, occlusion, periodontal screening, medical history update. Specific findings, not just "exam performed."
Patient's medical history should be reviewed and updated at every periodic evaluation. Document any changes or confirm no changes.
If bitewings or other x-rays are taken at the same visit, they're billed separately (D0274, D0272, etc). The evaluation code doesn't include radiographs.
Delta Dental typically covers D0120 twice per calendar year. Some Delta Dental plans measure by rolling 6-month periods rather than calendar year. Check whether the patient's plan uses calendar year or rolling frequency before scheduling.
Aetna and MetLife generally follow the twice-per-calendar-year standard. Both require that D0120 is billed on a separate date from any definitive treatment. If you do the exam and a crown prep on the same visit, the exam may be bundled into the restorative code.
Medicaid plans vary significantly by state. Some cover D0120 only once per year. Some require specific documentation standards beyond what commercial plans expect. Verify the state-specific Medicaid dental guidelines.
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Learn about our billing servicesD0120 is the CDT code for a periodic oral evaluation on an established patient. It is the standard recall exam performed every 6 months.
Most plans cover D0120 twice per calendar year or once every 6 months. Frequency varies by plan.
No. They are mutually exclusive. Use D0150 for new or comprehensive evaluations and D0120 for periodic recall on established patients.
Search all 206 CDT codes in our dental coding guide.