One additional cleaning and one additional exam per year. But this one team wants to do the first follow up as a “fine scale” using the D1110 and then all of the subsequent appointments will be periodontal maintenance. Periodontal disease—literally, disease “around the tooth” - affects the gums and the bone to which a tooth is attached. Additional prophylaxes are optional and may be charged to the patient. IMS Signature Series Periodontal Maintenance Instrument Collection Ea 6012783 | Hu-Friedy (Hufriedy) - IM-D4910 Description: IMS Signature Series Periodontal Maintenance Instrument Collection Each Category: Instruments / Curettes / Scalers. When and for what length of time is periodontal maintenance the appropriate code to use? Dental professionals can be proud to recommend Colgate, a company known for both its researched products and its community outreach. D4910 Periodontal maintenance (Limit to once in a 12-month period, evidence of prior osseous surgery required) 46.00 Oral and Maxillofacial Surgery Tooth Extraction/Removal (Limit of once per tooth in a lifetime) D7140 Extraction, erupted tooth or exposed root (elevation and/or forceps removal) 52.00 Follow-up patients who have received active periodontal therapy (surgical or nonsurgical) are appropriately reported using the periodontal maintenance code D4910. Maintenance intervals for at-risk patients can and should vary. Parameter on Periodontal Maintenance Supplement. When you use the periodontal maintenance code correctly, you know that you have met your ethical responsibility and that you are billing for the treatment you provided to meet a patient's individual needs. However, if the treating dentist determines that a patient's oral condition can be treated with a routine prophylaxis, delivery of this service and reporting with code D1110 may be appropriate.” What to Do When a Patient Pressures You to Use D1110 Instead of D4910 Erika Spring, RDH, MEd, is the Founder and Owner of Spring Innovative. D4910 is a procedure that includes site specific root planing as needed in patients who have been treated for attachment loss. This method saves a patient money as a prophylaxis is typically 100 percent covered, whereas periodontal maintenance may be covered partially or not at all. - D4910 Periodontal Maintenance – Benefits for Periodontal Maintenance are provided only when MetLife has evidence of recent prior active periodontal therapy in two or more different quadrants. D4910 is a procedure that follows periodontal therapy and continues at varying intervals, determined by the dentist's clinical evaluation of the patient, for the life of the dentition. Periodontal Maintenance Kit IM-D4910 Hu-Friedy has created a collection of procedural instrument kits that follow American Dental Association (ADA) - Current Dental Terminology (CDT) Coding. As a practicing hygienist, Erika learned how communication and systems go hand-in-hand to increase case acceptance. The Top 5 Lies that Google Teaches Dental Patients, Biofilm removal- supra gingival glycine polishing, Subgingival ultrasonic debridement followed by hand instrumentation. Like any hygiene appointment, assessment is key. My focus this month is not to … Full-mouth probing to identify target areas of inflammation, pocket depth, and calculus accumulation is imperative. periodontal maintenance code D4910. Site-specific root debridement if indicated. D4910 periodontal maintenance This procedure is instituted following periodontal therapy and continues at varying intervals, determined by the clinical evaluation of the dentist, for the life of the dentition or any implant replacements. Blair, C. (2013). However, improving your reimbursement for Periodontal Maintenance doesn’t have to feel like an uphill battle. No. So what SHOULD you be covering in your 60-minute periodontal maintenance? Evaluate your perio maintenance patient with accurate data and compare the findings from 1, 2, or 3 years past. Getting reimbursed for Periodontal Maintenance (D4910) is a pain. (2002). It consists of appointments at regular intervals (every 3, 4 or 6 months) where the teeth are scaled and polished, plaque and bacteria are removed, and the root surfaces are kept smooth and deposit free. Age limitations removed, all other limitations apply. Do it right, and you can add thousands of dollars to your bottom line. By definition, the 4910 periodontal maintenance code is defined as the procedure following periodontal therapy and continues at varying intervals determined by the clinical evaluation. D4910 Periodontal Maintenance Treatment: Attachments: Periodontal Charting/Perio Chart. We know this is an issue, but do not know where to start. After all, a maintenance appointment after four quads of SRP should be a breeze, right? D4910 - Periodontal Maintenance* D4341 - Periodontal Scaling and Root Planing - 4 or more teeth per quadrant D4342 - Periodontal Scaling and Root Planing - 1-3 teeth per quadrant . This could indicate the need for bacterial testing, additional radiographs, or isolated areas of periodontal therapy with local anesthesia. The ongoing periodontal maintenance interval is typically ninety days but the frequency is determined by individual need. The ongoing periodontal maintenance visit included prophylaxis (D1110).” RDH mag did a great article on this in Feb 2014, which includes info about the above narrative. This code includes removal of bacterial plaque and calculus from supragingival and subgingival areas, along with site-specific scaling and root planing. If so, you NEED to make adjustments and consider the possibility for bacterial testing, a medical referral, or something as simple as an adjusted recare interval based on the patient’s needs. Otherwise, finding a history may be a challenge. It may be tempting to use the prophylaxis code to help your patients save money, but ethically, you must bill out the procedure that you performed. common limitation is two per 12-month period or calendar year. D1110 consists of the removal of plaque, calculus and stains from thetooth structures. Periodontal Maintenance (D4910) Perio Maintenance helps patients sustain periodontal health and aids in the prevention of bone loss. 2. These patients may ask you if they can just "get a regular cleaning." The ADA code description and insurance reimbursement for this procedure have undergone changes in the past few years. Periodontal maintenance: Code D4910. D4910 is a dental code that can cause confusion. All rights reserved. D4910 Periodontal maintenance $25 Additional periodontal maintenance procedures (beyond 2 per 12 months) $55 Periodontal charting for planning treatment of periodontal disease $0 Periodontal hygiene instruction $0 Removable Prosthodontics Includes up to 3 adjustments within 6 months of delivery. However, a patient alternating between the GP and periodontist might receive alternating D1110s and D4910s. The code for periodontal maintenance indicates that active periodontal disease is present and D1110 indicates otherwise. A few simple steps will guide you through the instrumentation process: During the appointment, be on the lookout for Increased BOP and pocket depths of areas of new disease. I spent about half my clinical career in periodontal practices, two to be specific. One reason is the higher fee charged for a D4910 periodontal maintenance than the fee for D1110 prophylaxis. D4910 Periodontal Maintenance D9430 Office Visit for Observation (during regularly scheduled hours, no other services performed) D9910 Application of Desensitizing Medicament Form NY81175B1 IC(10/06) Refer to the policy for complete details, limitations, and exclusions. Chicago, Illinois 60611 F 312.440.7494. www.ada.org. A prophylaxis is not payable with periodontal maintenance (D4910) or full-mouth periodontal scaling and root planing when rendered on the By definition, the 4910 periodontal maintenance code is defined as the procedure following periodontal therapy and continues at varying intervals determined by the clinical evaluation. As a result, alternating codes is never appropriate. Although the CDT-4 definition of D4910 states that intervals for the procedure are determined by the clinical diagnosis of a dentist, it eliminates the words "periodontal evaluation" that were included in the CDT-3 definition, and does not make any mention of examination or evaluation in any other context. It includes removal of bacterial plaque, calculus, from supra and sub-regions, and SITE specific SRP where indicated, as well as polishing the teeth1. The periodontist could provide ongoing periodontal maintenance while the GP … Periodontal Maintenance (D4910) Effective January 1, 2018, the Department of Health Care . Procedure code: D4910 plus D4381. Hygienists are critical in this role. © YYYY Colgate-Palmolive Company. I have had personal success with varied intervals from 2 months (for non-compliant geriatric patients) to 4-5 months. A perio office was the ability to see the trend to begin debridement procedures with glycine air.... 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