Find the code
Common Groupings
Name that treatment
When's that due?
What's that pay?
100

Adult Prophylaxis

D1110

100

An exam and x-rays 

Name a likely combination for a new patient aged 11 or older.

Procedure code D0150 -Comprehensive Dental Evaluation    AND

D0210- Intraoral Comprehensive series of radiographic images (aka Full mouth series or FMX)

100

D1120

Prophylaxis-child

100

A routine dental exam for members 21 and over 

Once every 12 months - per provider

Procedure code D0120

100

D0210

$40.00

200

Immediate upper denture

D5130

200

Regular dental cleaning and fluoride treatment  *

D1110 Prophylaxis adult or

D1120 Prophylaxis Child

and 

Topical Fluoride application- D1206 or D1208

*bonus 100 points if you got all 4 codes

200

D0274

Bitewings- Four radiographic images

200

Procedure D0210

Once every 36 months per provider

Full mouth series aka FMX

D0210:  Intraoral Comprehensive Series of Radiographic Images 

200

Orthodontic Retention

$244.00

D8680

300

Oral evaluation for a patient under the age of 3

D0145

300

Comprehensive orthodontic treatment of adolescent dentition and diagnostic casts

D8080 - Comprehensive ortho AND

D0460- diagnostic casts ( study models)

300

D4910

Periodontal Maintenance 

300

Regular cleaning for members under 21

Once every 6 months.

D1120

*may be affected by Caries Risk Assessment (CRA)

300

D1208 for a 4 year old

$18.00

Topical application of fluoride - excluding varnish – 


400

Two Bitewing radiographs

D0272

400

Caries Risk Assessment (CRA) bundle

Caries Risk Assessment: Low Risk D0601, Moderate Risk D0602 or High risk  D0603 

AND

Nutritional Counseling D1310


400

D0220 OR D0230 *

Periapical Radiographs (aka PAs)

Bonus 200 points if you can explain the difference between the two codes

400

Sealants*

Once per tooth every 36mo 

*bonus 100 points: what teeth are sealants a benefit for?

400

Resin-based composite - one surface anterior  *

$57.21

Procedure D2330

Bonus 200 points what is the replacement frequency for primary teeth vs permanent teeth

500

Panoramic Radiograph

D0330

500

What might a routine dental visit  (recall appointment) include?*

up to 1000 points available

100 points for each correct code
Exam (D0120 - periodic oral evaluation... D0145 oral evaluation for patient under 3 years of age... ) 

Cleaning  D1120  (Prophylaxis- child) or D1110 (prophylaxis- adult) or D4910 (periodontal Maintenance)

Fluoride (D1206 or D1206)

X-rays:  D0272- two bitewings / D0274-four bitewings and four to six D0230- periapical (PAs)

500

D0150

Comprehensive Oral Evaluation- New or established patient

500

Periodontal maintenance *

Once per calendar quarter in the 24 months following completed periodontal scaling and root planing (SRPs)

*Bonus 300 points if you can list out the 4 calendar quarters

500

Amalgam- three surfaces *


$57.00

Procedure D2160

Bonus 100 points- what color is this filling?

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