This code was created, in part, to give periodontists an exam/evaluation code. General Dentists are held to the same standard of care as Periodontists, and since a complete periodontal exam (CPE) for all adult patients is recommended annually, utilizing code D0180 (Comprehensive Periodontal Evaluation) can and should be utilized in general dental practices. It is a myth that this code can only be used in specialty clinics. According to the code description, this code can be used for either a new or established patient. If a new patient has signs or symptoms of periodontal disease or any risk factor associated with periodontal disease, it may be preferable to use this code rather than D0150 (Comprehensive Oral Evaluation), as D0180 includes all elements of a comprehensive restorative and periodontal exam. However, it would be inappropriate to report both D0150 and D0180 on the same visit.
For established patients, code D0180 may be used in the presence of signs/symptoms of periodontal disease, with a history of periodontal disease or other risk factors such as smoking/diabetes. It would also be acceptable to use for a past-due periodontal patient when more time is required to properly assess and diagnose their case. Offices may alternate between D0120 and D0180 for when a CPE is performed annually. A higher fee is acceptable for D0180 because of the extra time needed to conduct a full-mouth, six-point probing and recording for all teeth plus charting of recession, furcations, mobility, exudate, etc.
To put this into perspective, in our area, Delta Premier pays, on average, $82 for 0150, $48 for 0120 and $82 for 0180. Especially for those offices who are alternating 0120 and 0180 for their periodontally involved and at-risk patients, the difference adds up. Take for example, a practice with roughly 1,500 active patients of which 15% are periodontally involved, could see an increase in profits of over $6,500 – $13,000 just by alternating D0120 with D0180 annually.