The bottom line is that periodontal maintenance treats active disease, while a prophylaxis is preventative. 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. They simply know that one code has a much higher fee than the other. periodontal maintenance code D4910. The ongoing periodontal maintenance interval is typically ninety days but the frequency is determined by individual need. These patients may ask you if they can just "get a regular cleaning." 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. Supplement. We know this is an issue, but do not know where to start. common limitation is two per 12-month period or calendar year. Retrieved from. 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. Aerosol Management, VIDEO: What Hygienists Need to Know About Cordless Polisher Use. VIDEO: What Hygienists Need to Know About Eyewear Use for Safety... INFOGRAPHIC: The Smart Choice in Patient Comfort, VIDEO: Hygiene Chat – Moisture Control vs. 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. After all, a maintenance appointment after four quads of SRP should be a breeze, right? D4910 is a procedure that includes site specific root planing as needed in patients who have been treated for attachment loss. 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. However, a patient alternating between the GP and periodontist might receive alternating D1110s and D4910s. Patients who require D4910 follow-up care should receive as many per year as advised for appropriate treatment, regardless of insurance coverage. Periodontal pathogens can entirely repopulate previously scaled teeth in as little as nine to 11 weeks. As a result, alternating codes is never appropriate. While they may sound scarier, they’re actually quicker and easier than periodontal deep cleanings. Of course, I always tell people that following is a periodontal procedure; we should be doing periodontal maintenance, D4910. Periodontal maintenance This is the 2010 version of HCPCS D4910 - please refer to the 2016 HCPCS code set for the latest version. 211 East Chicago Avenue T 312.440.2500. D4910 is a dental code that can cause confusion. It also includes the usual time between patient set up, break down, and the quick stop to the staff lounge to stuff down a granola bar in transit! Parameter on Periodontal Maintenance Supplement. Periodontal maintenance is commonly (and mistakenly) thought to be the same thing as regular teeth cleanings. Site-specific root debridement if indicated. 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. Within your 60 minutes, of course, a comprehensive medical history review is indicated, as well as time for a doctor exam per your office protocols. Blair, C. (2013). D4910 Periodontal Maintenance Treatment: Attachments: Periodontal Charting/Perio Chart. 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. Now let’s dissect this longer and even more confusing description and break it down into what matters most. Explain to your patients that they have active periodontal disease, which requires you to remove bacteria and buildup from below the gum line with special instruments to help prevent further bone loss. Full-mouth probing to identify target areas of inflammation, pocket depth, and calculus accumulation is imperative. J Periodontol 2000;71:849-850. However, if the treating dentist deter-mines 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.” So they are saying that some people can be maintained with a prophylaxis. 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. If you have periodontal disease that has resulted in bone loss, gum “pockets” deeper than 4 millimeters, bleeding gums, exposed root surfaces, or if you have had periodontal surgery or root planning to treat periodontal surgery or root planning to treat periodontal disease, a regular cleaning is not appropriate. D9110 - Palliative Treatment Limited to four times per year. Maintenance intervals for at-risk patients can and should vary. Assisted Hygiene Part 1: Is Your Office Prepared? As a practicing hygienist, Erika learned how communication and systems go hand-in-hand to increase case acceptance. 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. 2. It is intended to control factors that can cause irritation and inflammation. The ADA Council on Dental Benefit Programs continually receives and addresses a variety of dental claim submission and adjudication. Additional prophylaxes are optional and may be charged to the patient. Are you finding the BOP and pocket depths are the same or is there a medical or oral-systemic link risk factor that pops-up? What to Do When a Patient Pressures You to Use D1110 Instead of D4910 Dry mouth means that patients with Sjögren’s syndrome are at increased risk for dental caries. My previous article on glycine air polishing points out the focus is predominately on biofilm disruption as the target of professional therapy. If his/her current insurance company covered the provided therapy, it may be easily proven. Twenty years later, what we know now is the days of aggressive osseous surgery have seen a shift to non-surgical treatment and proactive maintenance targeting biofilm. You can also help them visualize the inflammation and swelling in their gum tissue by using the probe feature of Gum Health Physical. I too, as a consultant, provide timelines and time frames to help clinicians stay efficient. 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 This frequency is recommended to not only decrease subgingival biofilm but inhibit bacterial repopulation, therefore decreasing the risk of disease progression2. 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