Benefits Connection User Tip: Procedure Code Searches

You’ve probably noticed on your dentist’s statement or your Explanation of Benefits (EOB) statement one or more codes. They may start with either the letter “D” or numeral “0,” followed by a four-digit number. Sometimes they include just the four-digit number.

These are procedure codes, which are used on claim forms throughout the country. Each code identifies a commonly accepted dental procedure. For example, D0120 (sometimes recorded as 00120 or 0120) is “periodic oral evaluation,” your routine dental exam. D1110 (sometimes recorded as 01110 or 1110) is “prophylaxis-adult,” or teeth-cleaning. These codes are regularly reviewed and updated by the American Dental Association’s Code Revision Committee.

Benefits Connection features a procedure code search. This enables you to obtain a procedure code number, its description, and the benefit percentage paid. To access this feature, visit our Web site at www.deltadentalnj.com and log onto Benefits Connection. Click “Benefits Inquiry.” On the left navigation bar under “Benefits Inquiry,” click “Procedure Code Search.”

You may search by procedure number or description.

You may also find out when certain procedures were performed and Delta Dental’s payment for those procedures by clicking on "Claims Inquiry” and then “Tooth/Procedure History Search.”