What should dental procedure codes D0150 (comp. oral eval) and D0210 (complete x-ray series) include? s?

I already posted here about in- network bad dentist in Illionois and have scheduled new appt with a different dentist. Called my insurance company to get a complaint form. They don't seem too concerned about paying this guy for services he did not perform and can not give me the specific definition for these codes on my EOB. They are the same codes on my EOB from last year in Indiana. Dentist in Indiana did complete exam of every tooth and full x-rays (bitewing and panoramic). Dentist in Illinois did 20 second exam of a couple of teeth (not kidding!), did not record anything and only did bitewing x-rays because he told me panoramic x-rays were a waste of time. He is billing of the exact same codes as my dentist in Indiana! What exactly should a COMPREHENSIVE oral evaluation include? What should COMPLETE x-rays include? Canceled husband's appt with the first dentist and he went to the second dentist and had the complete everything like we are used to. Should I pursue this?

What should dental procedure codes D0150 (comp. oral eval) and D0210 (complete x-ray series) include? s?
According to the CDT (current dental terminology) booklet release from the ADA...D0150 is a comprehensive oral evaluation. "This would include the evaluation and recording of the patients dental and medical history and a general health assessment" I'll be honest with you...of the two codes you gave this is the most vague. I have done exams that were comprehensive in a few minutes and some in 45 minutes (Depends on the number of problems and whether the dentist wants to go over all the problems the day of the appointment....some dentists especially if you are new will only discuss your chief concern on your first visit and discuss other problems later..I don't...but some do).


D0210 is intraoral-complete series (including bitewings). (D0330 is for a Pano). While this does not include a pano, it does include more than 2 to 4 bitewings. Most often this is approximately 18-20 radiographs with the bitewings. So it sounds like this guy could be ...well you know. I will also add a panoramic is great for diagnosing issues with the jaw....but is terrible at diagnosing decay. I would recommend them but can see why this dentist would argue to the contrary.


As for pursuing this , well if he is charging for it and not doing it then he is wrong but if the insurance companies aren't complaining then there isn't much you can do other than not recommend your friends to go there. Good Luck
Reply:If possible with all my new patients, I take a Full Mouth Series (FMS). This is 18 x-rays that will show all the teeth and get different views of them. I personally don't like panos, unless we're dealing with wisdom teeth (and usually I can get an x-ray of them with my FMS). Most insurance companies will allow a pano or FMS every 3 or 5 years. You get very detailed images of the teeth with this form of x-rays and though they are uncomfortable, they are very good for diagnosing. The Comp. exam should be where they look at all your teeth and if there is any work to be done, to discuss that with you. I hope this answers your question. Good luck!

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