Diagnostic, Re-evaluation, and Laser Coding Questions ANSWERED!

When or how D0180 be used?

In order to use the accurate codes, we need to look at 3 parts: 1) the general description of the section 2) the name/nomenclature and 3) the specific description. So let’s look at that for D0180.

General Description for D0100-D0999 I. Diagnostic:

D0180 comprehensive periodontal evaluation – new or established patient

      • This procedure is indicated for patients showing signs or symptoms of periodontal disease and for patients with risk factors such as smoking or diabetes.  It includes evaluation of periodontal conditions, probing and charting, evaluation and recording of the patient’s dental and medical history and general health assessment.  It may include the evaluation and recording of dental caries, missing or unerupted teeth, restorations, occlusal relationships and oral cancer evaluation.
      • This is means anyone showing ‘signs of perio’. In my CDT Shifts, I identified Red Flags. These are by no means complete but you do know that anyone with these conditions are probably perio patients. When I talk perio, I mean the entire continuum from gingival to bone loss.

What code is perio evaluation (4-6 weeks) after SRP? The post therapy evaluation could be coded D0171 re-evaluation – post-operative office visit

For periodontal treatment, is there a code that we can use if laser treatment is utilize for insurance purposes? There are no insurance codes, there are only procedure codes. There is not a specific code for laser disinfection. This has been a hot topic at the codes meeting year after year. The AAP is not in favor of specific code and go so far as to say the research isn’t definitive. My group disagrees but so far we haven’t been successful. They further say a laser is mode of treatment not different than an ultrasonic or hand scaling. Again, my DentalCodeology Consortium disagrees. To date, the only code is D4999 unspecified perio procedure, by report. By report means a narrative is required. Not a template, not boilerplate. A narrative that gives the medical necessity for the treatment which includes the diagnosis and risk assessment.

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