D0150 - Comprehensive Eval

New or established patient comprehensive evaluation.

Procedure Code
D0150
Category
Diagnostic

Insurance Verification Benchmarks & Billing Guidelines

Benchmark Policy Source: Delta Dental National / PPO Standard

Frequency Limitation
1 per patient every 36 to 60 months (3 to 5 years) per provider/practice (ROLLING_MONTHS)
Age Limitation
Covered for ages 3 and older.

Required Claim Attachments & Pre-Submission Checklist

  • Full periodontal screening (PSR or 6-point charting)
  • Hard and soft tissue oral cancer screening documentation
  • Full-mouth caries charting and updated medical history

Bill When (Allowable Clinical Criteria)

  • New patient comprehensive initial baseline examination
  • Established patient returning after an absence of 3 or more consecutive years

Restrictions & Clinical Exclusions

  • Do NOT bill at routine 6-month recall visits (use D0120 instead)
  • Do NOT bill more than once every 3 years for an active patient

Common Claim Denial Codes & Overturn Strategies

Denial CodeDenial ReasonAppeal & Overturn Strategy
CO-119Frequency limit exceeded (billed within 36 months of previous comprehensive exam)Resubmit as D0120 (Periodic Evaluation) if within the 3-year frequency window.

ICD-10 Justification & Crosswalk Mappings

ICD-10 CodeDiagnosis NameCategoryPrimary JustificationClaim TypeClinical Scenario
Z01.20Encounter for dental examination and cleaning without abnormal findingsEncounter for other special examination without diagnosisYes (Primary)BOTHcomprehensive oral evaluation – new or established patient indicated for Encounter for dental examination and cleaning without abnormal findings
Z01.21Encounter for dental examination and cleaning with abnormal findingsEncounter for other special examination without diagnosisSecondaryBOTHcomprehensive oral evaluation – new or established patient indicated for Encounter for dental examination and cleaning with abnormal findings
Z13.84Encounter screening for dental disordersEncounter for screening for other diseases and disordersSecondaryBOTHcomprehensive oral evaluation – new or established patient indicated for Encounter screening for dental disorders
Z86.16Personal History of COVID-19Personal history of certain other diseasesSecondaryBOTHcomprehensive oral evaluation – new or established patient indicated for Personal History of COVID-19
U07.1COVID-19Emergency use of U07SecondaryBOTHcomprehensive oral evaluation – new or established patient indicated for COVID-19