D8670 Dental Code: Periodic Orthodontic Visit Billing

What D8670 covers

D8670 reports a periodic visit during active orthodontic treatment, billed as part of the treatment contract. In the chair, that’s the routine adjustment appointment: a wire change, a check on tooth movement, a tweak to the appliance, the visit that happens every four to eight weeks while the patient is in braces or aligners. The code reports that ongoing care as it draws against the comprehensive case the patient and carrier already agreed to.

The defining feature is in the descriptor itself: this visit is part of a contract. D8670 does not stand on its own. It assumes there is an active comprehensive orthodontic case on file, billed under D8080 for the adolescent dentition or D8090 for the adult dentition, and it reports the periodic care delivered under that case. Strip away the contract and D8670 has nothing to attach to.

What D8670 is not

• A standalone office visit or exam. D8670 is not a per-appointment fee you bill every time the patient sits in the chair. It reports periodic treatment under an existing contract, on the carrier’s installment schedule, not on the appointment calendar.
• A pre-treatment monitoring exam. Watching a growing patient before active treatment starts is D8660, not D8670. See the comparison below.
• The retention phase. Removing appliances and placing retainers at the end of treatment is D8680. Once you’re debanding, you’re out of the D8670 period.
• The comprehensive case fee itself. The case fee is D8080 or D8090. D8670 is the periodic visit that draws against that fee, not a second charge on top of it.
• Limited treatment. Limited orthodontic treatment has its own family of codes by dentition (D8010 through D8040). D8670 attaches to a comprehensive case, not a limited one.

Where it sits in the treatment timeline

The orthodontic codes that get confused with D8670 all touch the same patient at different points. What separates them is when in treatment the code applies.

• Before active treatment: D8660, the pre-orthodontic exam to monitor growth and development. You’re tracking a patient who isn’t ready for, or doesn’t yet need, appliances.
• The case itself: D8080 (adolescent dentition) or D8090 (adult dentition), the comprehensive treatment fee. This is the contract.
• During active treatment: D8670, the periodic visits that draw against that contract.
• End of treatment: D8680, retention, removing appliances and placing retainers.

Get the timeline right and the code follows. The most common conceptual mistake is treating D8660 and D8670 as interchangeable “ortho visit” codes. They aren’t. D8660 is watching and waiting; D8670 is treatment in progress.

How D8670 draws against the case fee

This is where the billing logic lives, and where most of the confusion comes from. D8670 is rarely a fee in its own right. It is how the comprehensive case fee gets paid over time.

Plans handle the case fee one of two broad ways, and that decides what D8670 does:

• Installment-paid cases. The carrier pays the comprehensive case fee in pieces over the course of treatment rather than all at once. In this model, D8670 is the trigger for each installment. A common pattern is an initial payment at banding, then scheduled payments at intervals such as 6, 12, and 18 months, with a D8670 claim submitted to release each one. The payment that comes back is part of the original approved case fee, not an additional amount.
• Up-front cases. The carrier pays the comprehensive case in a lump sum tied to D8080 or D8090, and treats the periodic visits as already covered. Here the D8670 claim is largely informational: it tells the carrier treatment is ongoing, but it doesn’t release a separate payment.

How you bill D8670 is decided by how the carrier pays the case. Confirm that for each plan before you build the recurring claims. Setting up monthly D8670 claims on a plan that paid the case up front just generates denials and noise.

When to bill D8670

Bill D8670 when:

• A comprehensive orthodontic case is active for the patient under D8080 or D8090 with that carrier.
• The patient is in active treatment, attending periodic adjustment visits.
• The carrier’s payment model calls for periodic claims, either to trigger an installment or to report ongoing treatment.

Do not bill D8670 for:

• A pre-treatment patient you’re only monitoring (use D8660).
• The visit where you remove appliances and place retainers (use D8680).
• Every individual chair visit when the carrier pays on a fixed installment schedule. Bill on the carrier’s schedule, not per appointment.
• A patient with no comprehensive case on file. There’s nothing for the periodic visit to draw against.

What gets a D8670 claim paid

The periodic claim has to point the carrier back to the right contract at the right point in treatment. The pieces that do that:

• The original appliance-placement date. This is the start of the contract and the anchor the carrier uses to place the visit in the treatment timeline. On the ADA claim form this is the “date appliance placed” field. Leave it off and the carrier can’t tell which case the visit belongs to.
• Months of treatment. Elapsed or remaining months tell the carrier where in the installment schedule this claim falls. A periodic claim at month 12 of an 18-month case maps to a specific installment.
• The link to the original approval. If the carrier issued a predetermination or approval number for the comprehensive case, reference it so the periodic claim attaches to that approval.
• The orthodontic indicator. Mark the claim as orthodontic treatment so it routes against the ortho benefit, not a general medical or basic benefit.

A short narrative noting months elapsed and remaining can help on plans that want it, but on a clean installment claim with the placement date and approval reference, it’s often unnecessary.

D8670 versus the codes around it

These codes share the orthodontic patient but report different things at different points.

D8670 (periodic orthodontic treatment visit, part of contract) answers: what ongoing periodic care is being delivered under the active case, and where in the installment schedule are we? It assumes a comprehensive case exists.

D8660 (pre-orthodontic treatment examination to monitor growth and development) answers: how is this not-yet-in-treatment patient developing? It’s a watching code, used before active treatment.

D8080 / D8090 (comprehensive orthodontic treatment, adolescent / adult dentition) answers: what is the full case being treated, and what is the total contracted fee? This is the contract D8670 draws against. D8080 is the adolescent dentition; D8090 is the adult dentition.

D8680 (orthodontic retention) answers: appliances are coming off and retainers are going in. This is the end of treatment, after the D8670 period.

The mistake to avoid is reaching for D8670 outside its window. Before the case starts, it’s D8660. The case fee is D8080 or D8090. The end is D8680. D8670 is specifically the middle, the active-treatment periodic visit, and only when a contract is behind it.

What to get right in your PMS

The exact menus and fields differ across Open Dental, Dentrix, Eaglesoft, Curve, and Carestream, but the setup that prevents problems is the same:

1. Tie D8670 to the comprehensive case, not to individual appointments. Set up the periodic billing so it follows the carrier’s installment schedule and references the original case, rather than firing a claim on every chair visit. Many systems have an ortho auto-claim feature for exactly this. Configure the interval to match the plan, not the recall schedule.
2. Store the original appliance-placement date on the case. Every periodic claim needs it. Capture it once when the case starts and let the system carry it onto each D8670 claim.
3. Record how each carrier pays the case. Flag whether the plan pays in installments (D8670 triggers payment) or up front (D8670 is informational). This decides whether the periodic claim should even go out.
4. Keep the patient’s responsibility tied to the case fee, not the visit. The patient owes their share of the contracted comprehensive fee, spread over treatment. Don’t let the system generate a separate patient charge per D8670 visit unless the plan’s contract actually allows it.
5. Reconcile installments against the approved case fee. When a periodic payment comes in, post it against the original case balance. It’s part of the approved fee, not new revenue, so the ledger shows the case drawing down rather than a stack of separate visit charges.