D8660Pre-Orthodontic Treatment Examination to Monitor Growth and Development

What This Code Covers

D8660 covers a pre-orthodontic treatment examination to monitor growth and development. This is a periodic check-up performed by the orthodontist to track a child's dental and skeletal development before starting active orthodontic treatment. The exam helps determine the optimal timing for treatment and may include clinical examination, review of growth patterns, and assessment of erupting teeth. This is not a general dental evaluation.

Billing Guide

Bill this code when:

• An orthodontist monitors a child's growth and development before treatment
• The exam is specifically for pre-orthodontic assessment and timing
• No active orthodontic treatment is being provided at this visit
• The visit is part of an observation/monitoring program

Do not bill this code when:

• An active orthodontic treatment adjustment is performed (included in the comprehensive fee)
• A general dental evaluation is being conducted. Use D0120 or D0150
• The initial orthodontic consultation and records are taken. Use separate evaluation codes
• The patient is already in active orthodontic treatment

Insurance and Denial Prevention

Key Payer Rules:

• D8660 is covered by some plans as a separate orthodontic benefit
• Some plans include growth monitoring visits under orthodontic benefits; others exclude them
• D8660 typically has a low fee and modest reimbursement
• The visit should be clearly distinct from general dental evaluations

Common Denials and How to Respond:

• Not a covered benefit - Some plans do not cover pre-orthodontic monitoring. Verify benefits.
• Should be a dental evaluation - Clarify that D8660 is an orthodontic-specific growth monitoring exam, not a general dental evaluation.
• Frequency limit - Some plans limit D8660 to once or twice per year during the monitoring period.