How often should we spot probe, and what code should we report?

Answer

The purpose of a periodic oral evaluation (D0120) is to determine any changes in the patient’s dental and medical health status since a previous comprehensive or periodic evaluation. As mentioned earlier, I probe every sulcus/pocket at every hygiene visit, since it is a quick way to assess any significant changes.

In its publication, 2007 Current Procedural Terminology for Periodontics & Insurance Reporting Manual, the AAP clarifies that a periodic oral evaluation (D0120) includes periodontal screening and should be performed at all periodontal maintenance appointments and reported separately. Sixpoints-per-tooth probing is considered periodontal screening. However, when a periodontal maintenance patient requires evaluation and a comprehensive periodontal charting (e.g., documenting pocket depths, recessions, furcations, bleeding points, minimally attached gingiva, etc.), then D0180 should be reported instead of D0120.

Currently, there is no specific code for reporting post-op probing depths four to eight weeks after initial therapy. Your only option is to report D4999 (unspecified periodontal procedure, by report), which is seldom paid, or include it in your active therapy fee.

By: Kathy S. Forbes, RDH, BS (August 2008)