Summary & Overview
CDT D1120: Prophylaxis—Child
Headline: CDT code D1120: Pediatric dental prophylaxis defined and used across major payers
Lead: CDT code D1120 denotes prophylaxis for children — a routine preventive dental cleaning performed in dental offices to remove plaque and deposits and to maintain oral health. As a common pediatric preventive procedure, D1120 is widely recognized in clinical practice and payer guidelines.
What the code represents and why it matters: CDT code D1120 covers professional prophylaxis services for pediatric patients. Preventive dental care for children is central to early detection and prevention of dental disease, reducing future treatment needs and supporting overall health. Nationally, consistent recognition of a pediatric prophylaxis code supports standardized billing, care delivery, and coverage decisions.
Key payers covered: This publication examines coverage and billing context for Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, reflecting practices among major commercial insurers.
What readers will learn: The article provides a concise clinical and billing overview of CDT code D1120, its role in preventive dental care, common clinical indications, and relationships to adjacent CDT procedures. It summarizes how major payers classify and reimburse pediatric prophylaxis services, highlights typical site-of-service expectations, and identifies common associated diagnostic contexts. Where specific operational or payer policy details are not supplied, the reader will see “Data not available in the input.”
Billing Code Overview
CDT code D1120 represents Prophylaxis–child, a preventive dental service focused on the cleaning and removal of plaque, calculus, and stains for pediatric patients. This service is typically performed to maintain oral health and reduce risk of caries and periodontal disease.
Service Type: Preventive dental service
Typical Site of Service: Dental office (CDT/ADA typical setting)
Clinical & Coding Specifications
Clinical Context
A 6-year-old child presents to a dental office for a routine preventive visit. The parent reports no current dental pain; the dentist performs an oral evaluation, records growth and eruption patterns, reviews home care, and completes a professional dental cleaning targeted to remove supragingival plaque and calculus appropriate for a child. The visit is documented as prophylaxis for a child and linked to the dental encounter diagnosis. Radiographs or fluoride application may be performed during the same visit if clinically indicated and documented separately.
Coding Specifications
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Modifier
52– Reduced ServicesUsed when the full dental prophylaxis procedure for which CDT code
D1120is reported is partially reduced or eliminated at the dentists discretion. Documentation must support the reduction in scope and the reason for reporting reduced services. -
Modifier
76– Repeat Procedure by Same DentistUsed when the exact same CDT code
D1120has been performed previously by the same dentist during the relevant reporting period and the procedure is being repeated. Documentation must indicate date and reason for the repeat. -
Associated provider taxonomies: