[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-572496-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-572496-en":127},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","2024-list-of-covered-dental-procedures","2024 List of Covered Dental Procedures","","2024 List of Covered Dental Procedures compiles dental service codes with service descriptions and administrative frequency limits tied to Clear Spring. Entries include diagnostic oral examinations, radiographs such as bitewings, periapicals, and panoramic imaging, and preventive cleanings and fluoride applications. It also covers basic restorative fillings with detailed constraints by material and number of surfaces, specifying permitted combinations and intervals per patient and provider/location. The document organizes items by code and PBP category such as Preventive and 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does the document list for each dental procedure code?","Question",{"text":63,"@type":64},"Each entry includes a procedure code, a description of the service, administrative frequency-limit guidance, and a PBP category such as Preventive or Restorative.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How are preventive oral exams and periodontal evaluations scheduled?",{"text":68,"@type":64},"The diagnostic section specifies allowed counts and intervals (for example, periodic and comprehensive evaluations) by code, per patient and provider/location, as well as re-evaluation conditions where applicable.",{"name":70,"@type":61,"acceptedAnswer":71},"What constraints apply to restorative filling codes?",{"text":72,"@type":64},"Restorative entries define permitted surface counts and materials (amalgam or resin-based composites) along with timing limits per tooth, per surface, per patient, and rules restricting overlap with certain crown services.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},572496,1792087678,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,114,119,124],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social 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Category |\n| --- | --- | --- | --- |\n|  | Diagnostic (Exams or Preventive Oral Exams) |  |  |\n| D0120 | Periodic oral evaluation | Two (D0120, D0160, D0170) every 12 months, per patient | Preventive |\n| D0140 | Limited oral evaluation | 3 per 12 months not allowed with routine services | Preventive |\n| D0150 | Comprehensive oral exam | One of (D0150, D0180) every 36 months, per provider or location. One of D0120, D0150, D0180 per 6 months per provider or location. | Preventive |\n| D0160 | Extensive oral exam problem focused | Two (D0120, D0160, D0170) every 12 months, per patient | Preventive |\n| D0170 | Re-evaluation-limited problem focused | Two (D0120, D0160, D0170) every 12 months, per patient | Preventive |\n| D0180 | Comprehensive periodontal evaluation | One of (D0150, D0180) every 36 months, per provider or location. One of D0120, D0150, D0180 per 6 months per provider or location. | Preventive |\n|  | Radiographs (Dental-X-rays) |  |  |\n| D0210 | Intraoral-complete series | One of (D0210, D0330, D0277) every 36 months, per patient | Preventive |\n| D0220 | Intraoral periapical-1st radiographic image | One of D0220, per date of service. | Preventive |\n| D0230 | Intraoral periapical-each additional radiographic image |  | Preventive |\n| D0240 | Intraoral occlusal radiographic image | Two per 24 months | Preventive |\n| D0270 | Bitewing-single radiographic image | One of (D0270, D0272, D0273, D0274) every 12 months, per patient | Preventive |\n| D0272 | Bitewing-two radiographic images | One of (D0270, D0272, D0273, D0274) every 12 months, per patient | Preventive |\n| D0273 | Bitewing-three radiographic images | One of (D0270, D0272, D0273, D0274) every 12 months, per patient | Preventive |\n| D0274 | Bitewing-four radiographic images | One of (D0270, D0272, D0273, D0274) every 12 months, per patient | Preventive |\n\n\n| Codes | Description of Service | DQ Standard Administrative Guidelines Will be reflected to reflect Clear Spring's frequency limits | PBP Category |\n| --- | --- | --- | --- |\n| D0277 | Vertical bitewings-7 to 8 radiographic images | One of (D0210, D0330, D0277) every 36 months, per patient | Preventive |\n| D0330 | Panoramic radiographic image | One of (D0210, D0330, D0277) every 36 months, per patient | Preventive |\n|  | Preventive (Cleanings) |  |  |\n| D1110 | Phrophylaxis-adult | Two of (D1110, D4346, D4910) every 12 months | Preventive |\n|  | Fluoride |  |  |\n| D1206 | Topical application of fluoride varnish | 2 of (D1206, D1208, D9910) per\u003Cbr>12 months | Preventive |\n| D1208 | Topical application of fluoride | 2 of (D1206, D1208, D9910) per\u003Cbr>12 months | Preventive |\n|  | Basic Restorative (Fillings) |  |  |\n| D2140 | Amalgam-one surface, primary or permanent | One of (D2140, D2150, D2160, D2161, D2330, D2331, D2332, D2335, D2390, D2391, D2392, D2393, D2394, D2990), one restoration per tooth, per surface, once in 24 months per patient-Do not allow any of D2140, D2150, D2160, D2161, D2330, D2331, D2332, D2335 once D2390 or other crown service paid. | Restorative |\n| D2150 | Amalgam-two surfaces, primary or permanent | One of (D2140, D2150, D2160, D2161, D2330, D2331, D2332, D2335, D2390, D2391, D2392, D2393, D2394, D2990), one restoration per tooth, per surface, once in 24 months per patient-Do not allow any of D2140, D2150, D2160, D2161, D2330, D2331, D2332, D2335 once D2390 or other crown service paid. | Restorative |\n| D2160 | Amalgam-three surfaces, primary or permanent teeth | One of (D2140, D2150, D2160, D2161, D2330, D2331, D2332, D2335, D2390, D2391, D2392, D2393, D2394, D2990), one restoration per tooth, per surface, once in 24 months per patient-Do not allow any of D2140, D2150, D2160, D2161, D2330, D2331, D2332, D2335 once D2390 or other crown service paid. | Restorative |\n\n\n| Codes | Description of Service | DQ Standa","cbCaiiHmIBYS3WlM","https://ap.wps.com/l/cbCaiiHmIBYS3WlM","pdf",345267,38,"English","# Diagnostic (Exams or Preventive Oral Exams)\n# Radiographs (Dental-X-rays)\n# Preventive (Cleanings)\n# Fluoride\n# Basic Restorative (Fillings)","[{\"question\":\"What does the document list for each dental procedure code?\",\"answer\":\"Each entry includes a procedure code, a description of the service, administrative frequency-limit guidance, and a PBP category such as Preventive or Restorative.\"},{\"question\":\"How are preventive oral exams and periodontal evaluations scheduled?\",\"answer\":\"The diagnostic section specifies allowed counts and intervals (for example, periodic and comprehensive evaluations) by code, per patient and provider/location, as well as re-evaluation conditions where applicable.\"},{\"question\":\"What constraints apply to restorative filling codes?\",\"answer\":\"Restorative entries define permitted surface counts and materials (amalgam or resin-based composites) along with timing limits per tooth, per surface, per patient, and rules restricting overlap with certain crown services.\"}]","2024 List of Covered Dental Procedures | PDF",1791927748,13]