The short version
# D0180 Dental Code: Comprehensive Periodontal Evaluation
D0180 is the CDT code for a comprehensive periodontal evaluation of a new or established patient who shows signs, symptoms, or risk factors for periodontal disease. The dentist records full-mouth periodontal findings, health history, and the information needed for diagnosis and treatment planning. Billing a routine recall exam as D0180 can trigger a denial, while undercoding a true periodontal workup loses the record's clinical detail.
- Bill D0180 when the service is a comprehensive periodontal evaluation for a patient with periodontal signs, symptoms, or meaningful risk factors.
- D0120 updates an established patient's general status. D0150 creates a comprehensive oral baseline. D0180 centers the comprehensive work on periodontal conditions.
- Full-mouth probing and periodontal charting are core parts of D0180, along with the histories, general health assessment, and oral cancer evaluation.
- D4355 can't share the date with D0180 because the debridement exists to make the comprehensive periodontal evaluation possible at a later visit.
- In a worked PPO example, a $150 fee becomes a $110 allowable. The plan pays $110 at a hypothetical 100% diagnostic benefit, the patient owes $0, and the office adjusts $40.
- Record six-site probing, recession, attachment levels, bleeding, mobility, furcations, radiographic bone findings, risk factors, diagnosis, and treatment plan.
What is D0180?
D0180 reports a full periodontal evaluation for a new or established patient. The work goes beyond a screening. It establishes the condition of the supporting tissues and supplies the measurements, history, and risk information the dentist needs to diagnose periodontal disease and plan care.
| Fact | D0180 |
|---|---|
| CDT category | Diagnostic, clinical oral evaluations |
| Patient | New or established |
| Primary focus | Comprehensive periodontal condition |
| Required work | Full-mouth probing and periodontal charting |
| Current-code check | A proposed descriptor expansion was rejected by the ADA CMC in March 2025 |
| Public fee references | DC Medicaid: $69 adult and $77.50 under 21; Connecticut adult Medicaid: $97 in 2025 |
The ADA's 2025 Code Maintenance Committee report shows that the committee rejected proposed added wording because it didn't improve the existing D0180 entry.
When do you bill D0180?
Bill D0180 when the patient presents with signs or symptoms of periodontal disease or risk factors that support a comprehensive periodontal workup.
- Complete full-mouth probing and charting rather than a limited periodontal screen.
- Record bleeding, recession, attachment levels, mobility, furcations, and mucogingival findings where present.
- Review radiographs for bone levels and patterns of loss.
- Update dental, medical, medication, tobacco, and other relevant risk histories.
- Establish the periodontal diagnosis and treatment or referral plan.
The ADA's coding article contrasts D0180 with D0120 and D0150 by pointing to signs or symptoms of periodontal disease.
D0180 vs D0120 and D0150
Choose the evaluation that matches the dominant scope of the visit, not the code with the highest allowable.
| D0120 periodic evaluation | D0150 comprehensive evaluation | D0180 | |
|---|---|---|---|
| Patient | Established | New or established in qualifying circumstances | New or established |
| Main purpose | Find changes since the prior exam | Establish a broad oral baseline and treatment plan | Establish the complete periodontal condition |
| Periodontal work | Screening or charting as needed | May include screening or charting | Full-mouth probing and charting |
| DC Medicaid adult fee | $31 | $69 | $69 |
A patient can need broad restorative and periodontal planning, but the office still reports one evaluation code that best describes the service. D0180 fits when the comprehensive periodontal assessment drives the visit. D0150 fits the broad comprehensive oral baseline described in its own entry.
D4355 sits before the evaluation.
What does insurance actually do with D0180?
Plans can put D0180 in the same evaluation frequency bucket as D0120 and D0150. The office must check all recent evaluation codes, not only the last D0180. Some plans also ask for the periodontal chart or prior treatment history when the claim pattern doesn't show why a comprehensive periodontal exam was needed.
Delta Dental's published quality guidance counts D0120, D0150, and D0180 as periodontal evaluation codes for adults with periodontitis. That quality measure doesn't establish coverage. It confirms that payers distinguish the comprehensive periodontal service from treatment codes such as D4341 and maintenance D4910.
- Office fee: $150
- Contracted allowable: $110
- Contractual adjustment: $40
- Plan payment at 100%: $110
- Patient balance: $0
Why does D0180 get denied?
- The chart doesn't go beyond a routine screen to full-mouth probing and charting.
- The history doesn't clear the plan's evaluation frequency limit.
- The dates don't separate D4355 from the later D0180 evaluation.
- The note doesn't identify periodontal signs, symptoms, risk factors, diagnosis, or treatment planning.
- The office can't support another evaluation code for the same visit.
If the record doesn't go beyond a recall exam, correct the code.
What documentation gets D0180 paid?
- Don't omit the complaint, periodontal history, systemic conditions, medications, tobacco use, or risk factors.
- Complete six-site full-mouth probing with bleeding and suppuration where present.
- Record recession, clinical attachment levels, mobility, furcations, and mucogingival findings.
- Attach or identify current diagnostic images and describe the bone-loss pattern.
- Don't omit the oral cancer evaluation or other oral findings.
- State the periodontal diagnosis, prognosis, treatment plan, maintenance interval, and referral decision.
Common questions about D0180
Can D0180 be used for an established patient?
Yes. D0180 applies to new or established patients when the dentist performs a comprehensive periodontal evaluation. Established status doesn't force D0120. The signs, symptoms, risk factors, and work completed must support the periodontal scope. Keep the full periodontal chart and the dentist's diagnosis in the record.
Can D0180 and D0150 be billed together?
Usually the dentist selects the one evaluation code that best describes the visit. D0150 and D0180 overlap in broad history and oral assessment, while D0180 requires the comprehensive periodontal focus. Check the plan before reporting unusual combinations and document separate work if a contract permits it.
Does D0180 include radiographs?
No. Radiographs are separately reported diagnostic procedures when clinically necessary. The D0180 record should identify the images reviewed and their periodontal findings. Each image code has its own frequency and coverage rules. Don't assume the evaluation benefit includes the imaging benefit.
Is D0180 required after D4355?
The later evaluation code depends on the service the dentist completes. The ADA says D0180 must occur after D4355 when a comprehensive periodontal evaluation is the planned service. D0120 or D0150 can fit when the dentist completes their full scope.
Check the chart before the evaluation claim
Before filing, confirm full-mouth probing, the periodontal diagnosis, and a later evaluation date when D4355 preceded the exam.
Sources
- ADA News, six CDT codes you should know
- ADA, Guide to Reporting D4355
- ADA, March 2025 Code Maintenance Committee report
- ADA, glossary of dental terms
- Delta Dental, periodontal evaluation quality guidance
- Washington, DC Medicaid fee schedule, May 17, 2025
- Connecticut Medicaid adult dental fee schedule, January 1, 2025
- FAIR Health Consumer, dental cost lookup
CDT codes and nomenclature are copyright © American Dental Association. This guide explains the code in plain language; the current CDT manual is the authoritative source.
