Can D0602 be used for all patients?

D0602 should be used when a patient is determined to be at moderate risk for caries, not for low or high-risk assessments.

How often can D0602 be billed?

Frequency depends on the insurance policy, but typically it can be billed once per assessment period as determined by the provider.

Is D0602 covered by insurance?

Coverage varies by insurance plan. It's important to verify with the patient's insurance provider prior to billing.

What is the difference between D0601, D0602, and D0603?

D0601 is for low risk, D0602 for moderate risk, and D0603 for high risk caries assessments.

D0602

Caries Risk Assessment - CDT Code Guide

Diagnostic/Tests and Examinations

Overview

The CDT code D0602 pertains to the caries risk assessment and documentation, specifically with a finding of moderate risk. This diagnostic procedure involves evaluating a patient's risk of developing dental caries using recognized assessment tools. Dental professionals use this code when they determine that a patient is at a moderate risk for caries, based on factors such as oral hygiene habits, dietary patterns, and previous dental history. Typically, this assessment is part of a comprehensive dental examination and is crucial for creating a personalized preventive care plan. By identifying patients at moderate risk, dentists can tailor interventions to prevent the progression of caries, thereby improving oral health outcomes.

When to Use This Code

During routine dental check-ups when a patient has a history of dental caries.
When a patient presents with dietary habits that increase caries risk.
For patients with inadequate oral hygiene practices.
In cases where there is a family history of dental caries.
When assessing new patients to establish a baseline caries risk.

Documentation Requirements

Detailed patient history including previous caries experience.
Assessment findings using recognized caries risk assessment tools.
Patient's dietary and oral hygiene habits.
Clinical observations and any relevant radiographic findings.
Documentation of the moderate risk determination and recommended preventive measures.

Billing Considerations

When billing for D0602, ensure that the assessment is documented thoroughly to justify the moderate risk finding. This code may not be covered by all insurance plans, so verifying patient benefits beforehand is advisable. Frequency limitations may apply, so check with the specific insurance provider. Common modifiers may include those indicating a new patient or additional services provided during the same visit.

Related CDT Codes

D0601 D0603 D0120 D0150 D0180

Frequently Asked Questions

Recognized tools include CAMBRA, ADA Caries Risk Assessment forms, and other evidence-based assessment tools.

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