D1310Nutritional Counseling for Control of Dental Disease

What This Code Covers

D1310 covers counseling a patient about how their diet affects their dental health. The provider discusses foods and beverages that contribute to decay or gum disease, recommends dietary changes to reduce caries risk, and may review frequency of snacking, sugar intake, and acidic food consumption. This is a separate billable service from the evaluation and is most commonly used for pediatric patients with high caries rates or adults with rampant decay.

Billing Guide

Bill this code when:

• Dedicated nutritional counseling is provided focused on dental disease prevention
• The counseling goes beyond what is typically included in a routine evaluation
• The patient has a documented high caries risk related to dietary habits
• The session is documented with specific dietary recommendations

Do not bill this code when:

• Brief dietary advice is given as part of a routine evaluation (this is considered part of the exam)
• No specific dietary counseling is documented in the chart
• The counseling is for general health purposes unrelated to dental disease
• The payer does not recognize D1310 as a covered benefit

Insurance and Denial Prevention

Key Payer Rules:

• Many commercial plans do not cover D1310 as a standalone benefit
• Medicaid programs in some states cover nutritional counseling for children with high caries risk
• When covered, D1310 is typically limited to one or two sessions per year
• Some payers may require documentation of high caries risk to justify the service

Common Denials and How to Respond:

• Not a covered benefit → Verify coverage. If not covered, bill the patient or provide as a value-added service.
• Bundled with evaluation → If the payer considers dietary counseling part of the exam, document that a separate, dedicated counseling session was provided.
• No documentation of need → Include the patient's caries risk assessment and dietary history in the claim.