What are 1st Look providers able to bill for?

What are 1st Look providers able to bill for?

• A. Initial oral assessment (once) under D0145 (oral exam less than 3 years old)
• B. Fluoride varnish application
• C. Sealants for primary teeth
• D. Radiographs for caries screening

Answer: (A)

The key idea here is that 1st Look is meant to provide a one-time, initial screening for very young children. The service coded as D0145 is an oral evaluation for a patient under three years old, delivered as a brief, initial assessment. That makes it the appropriate, billable service under the 1st Look program because it establishes a baseline and determines next steps without delivering additional preventive treatments in the same claim. While fluoride varnish, sealants, and radiographs are important preventive or diagnostic services, they are not the one-time initial assessment covered by this program. They would be billed separately in other contexts or visits, rather than as part of the initial screening.

The key idea here is that 1st Look is meant to provide a one-time, initial screening for very young children. The service coded as D0145 is an oral evaluation for a patient under three years old, delivered as a brief, initial assessment. That makes it the appropriate, billable service under the 1st Look program because it establishes a baseline and determines next steps without delivering additional preventive treatments in the same claim.

While fluoride varnish, sealants, and radiographs are important preventive or diagnostic services, they are not the one-time initial assessment covered by this program. They would be billed separately in other contexts or visits, rather than as part of the initial screening.