Knowing whether to report D0150, D0180, or a different exam code entirely can be confusing. Although both of these codes describe an oral evaluation, they serve very different clinical purposes. Understanding the requirements of each can help your team document accurately and support reimbursement reflective of the care delivered. Choosing the correct CDT code to report becomes much easier when you understand the similarities and differences between them. To help us do this, we need to know what these codes actually represent.
The American Dental Association (ADA) defines D0150 and D0180 as follows:
D0150 – COMPREHENSIVE ORAL EVALUATION – NEW OR ESTABLISHED PATIENT
D0180 – COMPREHENSIVE PERIODONTAL EVALUATION – NEW OR ESTABLISHED PATIENT
At first glance, these comprehensive evaluation codes appear virtually the same, with one key caveat – D0180 focuses specifically on periodontal health.
How to Report D0150
A common mistake dental practices make when deciding which code to report on the claim form is simply reviewing the code and its nomenclature (as shown above) without diving into each code’s descriptor (when applicable).
D0150 – COMPREHENSIVE ORAL EVALUATION – NEW OR ESTABLISHED PATIENT
Descriptor:
Used by a general dentist and/or a specialist when evaluating a patient comprehensively. This applies to new patients; established patients who have had a significant change in health conditions or other unusual circumstances, by report, or established patients who have been absent from active treatment for three or more years. It is a thorough evaluation and recording of the extraoral and intraoral hard and soft tissues. It may require interpretation of information acquired through additional diagnostic procedures. Additional diagnostic procedures should be reported separately.
This includes an evaluation for oral cancer, the evaluation and recording of the patient’s dental and medical history, and a general health assessment. It may include the evaluation and recording of dental caries, missing or unerupted teeth, restorations, existing prostheses, occlusal relationships, periodontal conditions (including periodontal screening and/or charting), hard and soft tissue anomalies, etc.
While the nomenclature for D0150 indicates that this is a CDT code for a comprehensive oral evaluation on new or existing patients, the descriptor tells us when and how to use this code.
For example, in order to be able to use this code for established patients, they must have had:
- a significant change in health conditions or other unusual circumstances; or
- been absent from active treatment for three or more years
In addition, a comprehensive oral evaluation (D0150) must include:
- a thorough evaluation and recording of the extraoral and intraoral hard and soft tissues
- an evaluation for oral cancer
- the evaluation and recording of the patient’s dental and medical history
- a general health assessment
A comprehensive oral evaluation (D0150) may include:
- interpretation of information acquired through additional diagnostic procedures (with the diagnostic procedures being reported separately)
- the evaluation and recording of
- dental caries,
- missing or unerupted teeth,
- restorations,
- existing prostheses,
- occlusal relationships,
- periodontal conditions (including periodontal screening and/or charting),
- hard and soft tissue anomalies, etc.
In short, D0150 sets the foundation for care. It captures the patient’s overall condition and provides detailed information necessary for the dentist to formulate a diagnosis to the highest level of specificity and create a treatment plan that would restore the patient’s oral health to form and function.
How to Report D0180
The CDT code for a comprehensive periodontal evaluation is often misunderstood and consequently reported incorrectly. As such, the ADA revised the nomenclature for CDT 2026 to clarify which will take effect on January 1, 2026. Take a look at the descriptor below and see if you can pinpoint key details required for reporting D0180 on the claim form.
D0180 – COMPREHENSIVE PERIODONTAL EVALUATION – NEW OR ESTABLISHED PATIENT
Descriptor (CDT 2026):
A comprehensive evaluation of periodontal conditions, including full mouth probing and periodontal charting. Indicated for patients exhibiting signs or symptoms of periodontal disease, systemic medical conditions, or patients with social risk factors. It includes an evaluation for oral cancer, an evaluation of the patient’s medical history, a general wellness assessment, and an evaluation of current dental conditions.
Regardless of whether a patient is new or established, D0180 should be reported instead of D0150 if the patient exhibits signs or symptoms of periodontal disease, systemic medical conditions, or has social risk factors. It’s also important to note that all CDT codes are available to any dentist practicing within their scope of license. You don’t have to be a periodontist to use D0180 – how cool is that?!
In addition, a comprehensive periodontal evaluation (D0180) must include:
- a comprehensive evaluation of periodontal conditions
- full mouth probing (six measurements per tooth) and complete periodontal charting
- an evaluation for oral cancer
- an evaluation of the patient’s medical history
- a general wellness assessment
- an evaluation of current dental conditions
D0180 is more detailed than a periodontal screening record (PSR). It includes six-point per-tooth probing and complete periodontal charting, and also identifies furcations, wear facets, abfraction lesions, areas of mobility, bleeding on probing, areas and amounts of recession, amount of remaining attached gingiva, etc. When reported correctly, the fee and reimbursement for D0180 may be higher than that of D0150.
The Importance of Documentation
Maintaining thorough and accurate dental records is crucial not only for patient care but also in mitigating risk. Can the patient’s clinical record pass the “Amnesia” test? If you forgot everything you know about a patient’s treatment, would the documentation provide a clear picture of what was performed on each date of service? Patient records can be called into evidence by a dental board or court of law at any time. If it’s not documented, it did not happen. If it’s written down, but no one can read it, it did not happen. At the end of the day, the dentist is ultimately responsible for the patient’s chart, including the diagnosis and CDT codes reported on the claim form.
Both D0150 and D0180 require an evaluation for oral cancer, with the findings documented in the clinical notes along with other items mentioned above. Whereas D0150 gives the option of periodontal screening or charting as necessary, D0180 requires a complete and comprehensive periodontal charting (six measurements per tooth) of all teeth.
If you’re unable to complete a comprehensive oral evaluation based on the requirements above, or you’re performing an evaluation limited to a specific oral health problem or complaint, click the hyperlinks to learn more about CDT codes D0140 and D9310 and find out if they’re more applicable. Remember, don’t forget to read the nomenclature and descriptor in full and always code for what you do!
Need Help Navigating CDT Codes?
If your team struggles with knowing when to use D0150 versus D0180 (or other codes) or you’re facing repeated claim delays and denials, eAssist can help. Schedule a complimentary consultation to learn how our expert billing team can simplify your documentation process, reduce denials, and help you get paid for the care you provide, accurately and on time.
Disclaimer: Insurance administration and dental billing recommendations presented here represent the opinions of the author or our staff and are for informational purposes only. You are responsible for your own use of the CDT Codes, insurance administration, and dental billing. For the latest CDT codes and official interpretations, contact the American Dental Association or visit ADA.org.
