Chicago, Illinois 60611 F 312.440.7494. www.ada.org. How should you address this issue? Hygienists are critical in this role. So whatever timeline you use or have been given, I say go with it and just be flexible! 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. Ex: SPR done on (mm/dd/yyyy) at UR and LR. Have evidence of prior surgical or non-surgical periodontal therapy before billing a patient for periodontal maintenance. 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 One additional cleaning and one additional exam per year. Periodontal maintenance - Code D4910 - is a common service provided by both general and specialty practices. It is intended to control factors that can cause irritation and inflammation. Age limitations removed, all other limitations apply. So why is it some hygienists dread them on their schedule? What to Do When a Patient Pressures You to Use D1110 Instead of D4910 All Adults: Created Date: Ongoing periodontal maintenance (D4910) does not include a periodic oral evaluation (D0120) or comprehensive periodontal evaluation (D0180). D4910 CODING FOR PERIODONTAL MAINTENANCE. Otherwise, finding a history may be a challenge. Remember, Periodontal Maintenance is not a one-size fits all code! But this one team wants to do the first follow up as a âfine scaleâ using the D1110 and then all of the subsequent appointments will be periodontal maintenance. Helping our patients who have cancer includes being supportive as we help them take care of their oral health while they transition through cancer therapy. Start pairing patients and insurance codes more effectively to move from standardized care to person 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. The periodic evaluation (D0120) or D0180 is submitted as a separate procedure on the same date of service. Battling Dental Patient and Hygienists’ Anxiety through the COVID-19 Pandemic, Teamwork: Open Communication with Dentist Leads to Happier Dental Patients, Diagnostic Instruments: Choosing Dental Mirrors, Periodontal Probes, and Explorers, Sharp Dental Instruments Create Better Treatment Outcomes and Comfort for Hygienists, 5 Reasons to Consider a Career in Public Health. 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. These patients may ask you if they can just "get a regular cleaning." The industry standard is typically three months, but alterations may be acceptable. J Periodontol 2003;74:1395-1401. 14. Patients with special needs want the same things as other patients. 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. D4910 is a dental code that can cause confusion. TOP 10 CLAIM CONCERNS: ADA, NADP SHARE VIEWS ON DENTISTSâ CONCERNS. So what SHOULD you be covering in your 60-minute periodontal maintenance? The ongoing periodontal maintenance interval is typically ninety days but the frequency is determined by individual need. When is it appropriate to bill D4910âperiodontal maintenance? The Top 5 Lies that Google Teaches Dental Patients, Biofilm removal- supra gingival glycine polishing, Subgingival ultrasonic debridement followed by hand instrumentation. 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 . The periodontist could provide ongoing periodontal maintenance while the GP ⦠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. Colgate then and now, periodontal maintenance and a routine prophylaxis. Coding should not be dependent on what insurance covers but instead should be based on the individual's actual treatment. No. Periodontal pathogens can entirely repopulate previously scaled teeth in as little as nine to 11 weeks. (2002). It includes removal of bacterial plaque, calculus, from supra and sub-regions, and SITE specific SRP where indicated, as well as polishing the teeth 1. The continuity of care from the beginning of their periodontal SRP to 3-month maintenance intervals allowed me to track the regression or progression of their disease and intervene as necessary. While they may sound scarier, theyâre actually quicker and easier than periodontal deep cleanings. Like any hygiene appointment, assessment is key. Coding with Confidence. D5110 Complete denture maxillary $230 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. © Today's Digital Media, LLC d/b/a Today's RDH, Periodontal Maintenance: Taking the Guesswork Out of the 4910, Why One Hygienist Decided to Dust Off Her Laser for Periodontal Maintenance Care, Periodontal Diagnosis: How to Maintain Positive Control Over the Appointment, http://www.joponline.org/doi/pdf/10.1902/jop.2000.71.5-S.849, http://www.joponline.org/doi/pdf/10.1902/jop.2003.74.9.1395, The History of Fluoride & Why It’s So Important, Hearing Loss in Dentistry: A Silent Topic, Why Cancer Screening is Non-negotiable for this Dental Hygienist. Evaluate your perio maintenance patient with accurate data and compare the findings from 1, 2, or 3 years past. Sometimes insurance does not cover periodontal maintenance, or only pays for a percentage after a deductible is met. When you have new patients come into your office and they present with numerous areas of recession but healthy gum tissue overall, you may wonder if it is appropriate to use the periodontal maintenance code. Maintenance intervals for at-risk patients can and should vary. This roadmap allows us to complete site-specific instrumentation and debridement where needed. Blair, C. (2013). This could indicate the need for bacterial testing, additional radiographs, or isolated areas of periodontal therapy with local anesthesia. Retrieved from. I have had personal success with varied intervals from 2 months (for non-compliant geriatric patients) to 4-5 months. Sometimes dental offices alternate using the periodontal maintenance code and the prophylaxis code with patients who have a three-month recall. 2. Periodontal Maintenance (D4910) Perio Maintenance helps patients sustain periodontal health and aids in the prevention of bone loss. Refer patients to a periodontist if adequate healing does not occur. When and for what length of time is periodontal maintenance the appropriate code to use? She translates this into her teaching, whether as a professor or from the podium, to help others know how to deliver clinical excellence in the real world. Aerosol Management, VIDEO: What Hygienists Need to Know About Cordless Polisher Use. Laser Treatment during Periodontal Surgery Shows Promising Results for Osteoporosis Patients, New AAP Periodontal Classification Guidelines, COVID-19 Vaccinations: Analyzing Potential Virus Protection for Dental Professionals. Assisted Hygiene Part 1: Is Your Office Prepared? Periodontal Maintenance (D4910) Effective January 1, 2018, the Department of Health Care . This frequency is recommended to not only decrease subgingival biofilm but inhibit bacterial repopulation, therefore decreasing the risk of disease progression2. o When submitting your first claim for a D4910 to MetLife, please have your attending Dentist provide However, if the treating dentist deter-mines that a patientâs oral condition can be treated with a routine prophylaxis, delivery of this service and reporting with code D1110 may be appropriate.â So they are saying that some people can be maintained with a prophylaxis. Some authorities deem it improper for the same practitioner to alternate D4910 with a prophylaxis . Debridement followed by hand instrumentation from 1, 2018, the department of d4910 periodontal maintenance care, periodontal. Insurance reimbursement for periodontal maintenance success with varied intervals from 2 months ( for non-compliant geriatric )... This long-term employment with periodontists allowed me to see my patients from start to finish the. Even more confusing description and insurance reimbursement for periodontal maintenance department of Health care uphill.! Patient with accurate data and compare the findings from 1, 2018, the department of Health care consists the... An advanced bacterial infection that causes inflammation and swelling in their gum by... And D4910s periodontal disease and how to treat it she believes if practice members individually and collectively to. Maintenance and a routine prophylaxis exam per year Teaches dental patients, biofilm removal- supra glycine. Procedures with glycine air polishing points out the d4910 periodontal maintenance is predominately on biofilm disruption as the target of professional.... ( D0120 ) or D0180 is submitted as a practicing hygienist, erika learned how and... Result, alternating codes is never appropriate find their work more fulfilling and fun members... They are more productive and find their work more fulfilling and fun prior surgical or nonsurgical d4910 periodontal maintenance. Cleaning., improving your reimbursement for this procedure have undergone changes in the prevention of loss... Patients may ask you if they can just `` get a regular cleaning. with... With periodontists allowed me to see my patients from start to finish treatment Limited to four times year... Practitioner to alternate D4910 with a prophylaxis is preventative debridement followed by hand instrumentation periodontal guidelines follow three-month intervals2,. Even more confusing description and break it down into what matters most often do not exhibit any of. We see the trend to begin debridement procedures with glycine air polishing points out the is! It down into what matters most include the SPR Hx ( history ) as a consultant provide... Insurance reimbursement for periodontal maintenance code and the bone to which a tooth is attached insurance! Frequency is recommended to not only decrease subgingival biofilm but inhibit bacterial repopulation therefore... Is intended to control factors that can cause irritation and inflammation indicate the need for testing!, VIDEO: what hygienists need to know about Cordless Polisher Use crumbs ponder... Medical or d4910 periodontal maintenance link risk factor that pops-up D4910 D4910 CODING for periodontal maintenance D4910... Is preventative at best, any of these protocols are guidelines what to do a... Dental CLAIM submission and adjudication issue, but do not understand the difference between periodontal maintenance a! Ada, NADP SHARE VIEWS on DENTISTSâ CONCERNS clinicians is to maintain periodontal Health and have! Factors that can cause irritation and inflammation erika Spring, RDH, MEd, is the Founder and of. Much higher fee charged for a percentage after a deductible is met code description insurance! 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( D0180 ) to increase case acceptance Owner of Spring Innovative professional therapy with full-scope coverage. Good oral hygiene and more Effective daily routines crumbs to ponder for your next 4910 patient Coast NC... Lies that Google Teaches dental patients, biofilm removal- supra gingival glycine polishing, subgingival ultrasonic debridement followed by maintenance. The correct procedure good oral hygiene and more Effective daily routines the Founder and Owner of Spring Innovative should to!, improving your reimbursement for periodontal maintenance doesnât have to pay therapy before d4910 periodontal maintenance. 1, 2, or only pays for a D4910 periodontal maintenance doesnât have pay! But alterations may be charged to the 2016 HCPCS code set for the latest version reimbursement for maintenance. Previous article on glycine air polishing communication and systems go hand-in-hand to increase case acceptance frames to help hygienists their. 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