D0145 is the CDT code for an oral evaluation performed on a child under three years of age, combined with counseling for the primary caregiver. The counseling component is built into the procedure: diet, oral hygiene instruction, fluoride, and caries risk assessment must be addressed with the parent or guardian. Use this code only while the patient is under three.
Get help with D0145 claims →Last updated June 2026 · Reviewed by the PracticeAlpha billing team
The patient must be under three years old at the date of service. This is the primary eligibility requirement. A child turning three the week after the visit does not qualify. Age at the time of the appointment determines the code.
The visit must include both an oral evaluation and counseling with the primary caregiver. Topics typically include proper brushing technique for infants, diet and bottle use, fluoride supplementation, and early caries risk factors. If the caregiver is not present and counseling cannot occur, the visit may not meet the full D0145 definition.
Do not bill D0145 on the same date as D0120, D0150, or D0180. Only one evaluation code per date of service. If a comprehensive evaluation is already on the claim for the same date, a payer will deny or bundle D0145.
The most common denial: the patient was three or older at the date of service. Payers verify the date of birth against the date of service. If the child turned three before the appointment, the code is invalid. Recode to D0150 for a comprehensive evaluation.
D0145 requires that counseling with the primary caregiver is documented in the clinical notes. If the notes say "exam" with no mention of counseling topics, the payer has grounds to deny or recoup. Write a brief summary of what was discussed with the parent or guardian.
Billing D0145 alongside another evaluation code on the same date triggers a bundling denial. One evaluation per date. If a more comprehensive evaluation code is already being billed, remove D0145 from the claim.
Some commercial plans do not cover D0145 as a distinct code. They may cover a child exam under D0150 or D0120 instead. Verify benefits before the appointment and counsel the family if the code is not covered.
Confirm the child is under three years old on the date of service. Note the date of birth in the clinical record to support the age-specific code.
Document all teeth present, eruption status, soft tissue condition, and any early caries findings or other clinical observations.
Record the child's caries risk level (low, moderate, or high) based on dietary habits, fluoride exposure, and clinical findings.
List the topics covered with the parent or guardian: tooth brushing technique, bottle/sippy cup habits, diet, fluoride, and next appointment timeline.
Note who was present for counseling. This supports the claim if a payer requests records to verify that counseling occurred.
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Learn about our billing servicesD0145 is the CDT code for an oral evaluation performed on a patient under three years of age. The procedure includes counseling with the primary caregiver on topics such as oral hygiene, diet, fluoride, and caries risk.
Any licensed dentist who performs the evaluation and caregiver counseling can bill D0145. Pediatric dentists use it most frequently, but general dentists who see young children are also eligible.
D0150 is a comprehensive evaluation for a new patient of any age. D0145 is age-restricted (under three) and requires the caregiver counseling component. The two codes should not be billed on the same date.
The most common reasons are: patient is three or older at the date of service, missing documentation of caregiver counseling, the plan does not cover this code, or it was billed alongside another evaluation code.
Yes. Because caregiver counseling is part of the procedure definition, clinical notes must confirm it occurred and describe the topics covered. A note that only records exam findings is insufficient.
Most plans allow it once per year for eligible patients under three. Some Medicaid programs encourage more frequent early childhood visits for high-risk infants. Verify the patient's specific plan.
Search all CDT codes in our dental coding guide.