EXAMS
X-RAYS
PREVENTIVE
RESTORATIVE
WHAT WOULD YOU BILL?
100

Established patient returns for a routine periodic oral examination

D0120

100

The first periapical radiographic image taken during the visit.

D0220

100

Routine adult prophylaxis.

Routine child prophylaxis.

D1110

D1120

100

An anterior tooth receives a one-surface resin-based composite restoration.

D2330

100

Tooth #S extraction, need a Band/Loop space retainer

D1510 fixed, unilateral

200

New patient receives a comprehensive oral evaluation

D0150

200

Each additional periapical radiographic image taken during the same visit.

D0230

200

How old is the patient when we need to put D1110 not D1120? 

14 for most insurances, 12 for Aetna and Guardian


200

An anterior tooth #E receives a MFL resin-based composite restoration.

D2332

200

Tooth #A and #J all prematurelly exfoliating, need a NANCE retainer

D1516 Space maintainer — fixed, bilateral, maxillary

300

Patient comes in because of a specific dental problem , such as toothache, trauma, and receives a limited problem-focused evaluation

D0140

300

Two bitewing radiographic images.

D0272

300

Fluoride varnish is applied to the teeth.

D1206

300

A direct resin-based composite crown (strip crown) is placed on an anterior tooth.

D2390

300

Tooth #T need to be extracted and have space mantainer

D1517Space maintainer — fixed, bilateral, mandibular

400

A child under age 3 receives an oral evaluation that includes counseling with the primary caregiver.

D0145

400

Four bitewing radiographic images.

D0274

400

A sealant is placed on a tooth to prevent or arrest pit-and-fissure caries.

D1351

400

Tooth #T  MO filling and #S DO filling

D2392

400

Tooth #B decay into pulp, need pulpotomy and SSC

D3220, D2930

500

A patient returns for a limited, problem-focused re-evaluation, such as trauma follow up

D0170

500

A panoramic radiographic image of the jaws.

D0330

500

SDF is applied to patient to arrest caries. What additional paper work need to be signed before we proceed to the procedure?

D1354

500

Tooth #A SSC

D2930

500

Tooth #T facial abscess, pulp necrotic, need pulpectomy to save the tooth and nitrous

D3240

D9230

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