Attention: All Physicians Guidance for Billing of Physician Fluoride Varnish Services - D0145 and D1206

Physician claims that include procedure codes D0145 (Oral evaluation for a patient under three years of age and counseling with primary caregiver) and D1206 (Topical application of fluoride varnish) must be billed in a particular order for both procedure codes to be paid correctly. Procedure code D1206 must be billed on the detail line before D0145.

NCTracks is designed to adjudicate one detail line at a time, beginning with the first detail line on the claim and proceeding through the last. NCTracks must recognize that D1206 has been paid before D0145 can be paid for the same date of service. Ensuring that physician claims are billed with the procedure codes in this order will expedite the processing and payment of these claims.

If the claim is originally submitted to NCTracks with the procedure codes in the wrong order and only D1206 is paid, the provider must submit a new claim for D0145 only.