Belle DuCharme

CDPMA, Dental Training Consultant

Code Tip: D0460 Pulp Vitality Tests

A pulp test is not a routine test for oral evaluation purposes and should not be done routinely before preparation of a crown or other restorative work on a vital tooth.  The pulp vitality code is a “stand-alone code” and should not be combined with definitive treatment on the same day of service. The code is variable in how it is paid. Some payers will not cover the code when it is combined with D0140 on the same day of service. Some payers will pay it when combined with the Palliative code D9110 and some will say it is inclusive. Some payers consider this code as basic care and others as preventive care. It is important to include a narrative that identifies the tooth, symptoms, the methods used to test the pulp and contralateral side tested results(away from the area of the chief complaint) and opposing teeth testing results also.

Dental Billing Tips and News for Pros; Edition #140


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