It has been a well-known, long-time issue in the dental treatment and billing world that there has been a great need for a code to bridge the gap between patients who only need a regular prophylaxis and those who are not quite to the scaling and root planing stage of treatment yet.
Since providers must bill for what they do, it has been a struggle on how to code and bill the patient who falls in the middle since billing only a prophylaxis would be considered under coding while billing a scaling and root planing would be considered over coding.
The American Dental Association Center for Dental Benefits, which is responsible for creating the CDT Coding manual used by all offices and insurance plans, has finally created a new CDT code for 2017 to address this very issue.
D4346 – Scaling in presence of generalized moderate or severe gingival inflammation – full mouth, after oral evaluation.
More guidance can be found at Download Guide to Reporting D4346.
I sure am happy to learn about this development in the coding system. I have long been frustrated with how to be reimbursed for necessary treatment that falls between a routine prophylaxis and the full scaling and root planing gap. It is a preventive service well worth receiving compensation for. Thanks to whomever has come up with this breakthrough.
That’s great news! I am equally happy about the implementation of this new code. Let’s hope the code is implemented into the Dental School!