D0180 is the CDT code for a comprehensive periodontal evaluation, used for new or established patients. It covers a detailed examination of the periodontal tissues, including full-mouth probing, bone level assessment, furcation involvement, mobility, and periodontal risk factors. This code is distinct from a routine comprehensive oral exam and is used specifically when a thorough periodontal workup is clinically indicated.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Get help with D0180 claims →Use D0180 when performing a thorough periodontal-focused evaluation that goes beyond the scope of a standard comprehensive oral exam. This code requires full-mouth periodontal probing with documentation, bone level assessment, furcation classification, mobility scoring, and a periodontal risk evaluation. The clinician reviews radiographs for bone levels as part of the exam.
Common clinical scenarios: New patient presenting with signs of gingival inflammation, bleeding, or bone loss. Established patient with a known history of periodontal disease being re-evaluated after a period away from the practice. Patient referred for periodontal consultation. Patient with systemic conditions that increase periodontal risk such as diabetes or smoking history.
Do NOT use D0180 for: Routine periodic oral evaluations (use D0120). Comprehensive oral evaluations focused on restorative needs without periodontal workup (use D0150). Periodontal maintenance visits where a separate evaluation is bundled (check payer policy before billing D0180 with D4910).
Many plans allow a comprehensive evaluation only once in a defined benefit period. Billing D0180 again before the allowed interval, without documenting a significant change in the patient's condition, results in denial. Check the patient's benefits before the visit and document any new clinical findings that justify a repeat evaluation.
D0180 requires a full-mouth periodontal chart. If the claim is reviewed and the record shows only a spot-check of a few teeth or a note that says "perio exam performed," it will not hold up. The chart must include probing depths, bleeding on probing, recession, furcation, and mobility on all teeth present. Missing this documentation is the most common reason D0180 gets denied on review.
Some payers bundle D0180 into the fee for a prophylaxis or periodontal maintenance visit. They view the evaluation as part of the hygiene appointment and will deny D0180 when billed on the same date as D1110 or D4910. Always check the patient's plan before billing both codes on the same date of service.
Billing D0180 when the service performed was a standard periodic exam is an audit trigger. The record must support a comprehensive periodontal-focused evaluation, not just a routine checkup. If the clinical notes describe a brief exam without full-mouth probing, D0180 is not the correct code.
Probing depths at six points per tooth, bleeding on probing, recession measurements, furcation classification, and mobility scores for all present teeth. This is the core documentation requirement for D0180.
Current bitewings or periapical films reviewed as part of the evaluation. Document findings such as bone loss pattern (horizontal or vertical), furcation involvement visible on radiographs, and crestal bone height relative to the CEJ.
Record the clinical findings in the note, the periodontal diagnosis (such as generalized moderate chronic periodontitis), and the recommended treatment plan. A diagnosis code (ICD-10) linked to the claim strengthens the record.
Note systemic conditions (diabetes, cardiovascular disease), tobacco use, medications that affect the periodontium, and patient oral hygiene habits. These factors support medical necessity and are part of a complete comprehensive periodontal evaluation.
D0180 is performed by a dentist or periodontist. Some payers require the evaluating provider to be listed on the claim. Ensure the rendering provider matches the credentialed provider in the payer system.
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Learn about our billing servicesD0180 is the CDT code for a comprehensive periodontal evaluation for new or established patients. It covers full-mouth periodontal probing, bone level assessment, furcation classification, mobility scoring, and risk factor evaluation. It is focused specifically on the periodontal condition, not a general oral exam.
Use D0150 for a comprehensive oral evaluation covering the overall condition of the mouth and dentition. Use D0180 when the evaluation is specifically focused on the periodontal tissues, including full-mouth probing and bone assessment. If the clinical record supports a complete periodontal workup, D0180 is appropriate.
Common denials come from frequency limitations, incomplete periodontal charting in the record, billing D0180 on the same date as a hygiene visit when the payer bundles it, and records that do not support a comprehensive periodontal evaluation.
A full-mouth periodontal chart with probing depths, bleeding on probing, recession, furcation, and mobility on all teeth. Current radiographs reviewed for bone levels. A clinical narrative with the periodontal diagnosis, risk factors, and treatment plan.
Some payers bundle D0180 into the hygiene visit and will deny it when billed on the same date as D1110 or D4910. Check the patient's specific plan before billing both codes together. When allowed, both are billable if clinically distinct services were rendered.
Most plans allow a comprehensive evaluation once per a defined benefit period, commonly once every 3 years or once per patient per office. Frequency limitations vary by payer. Document any new clinical findings that justify a repeat evaluation within the frequency window.
Search all 206 CDT codes in our dental coding guide.