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! D5110 Complete denture maxillary $230 Maintenance intervals for at-risk patients can and should vary. So whatever timeline you use or have been given, I say go with it and just be flexible! These patients may ask you if they can just "get a regular cleaning." Therefore, we see the trend to begin debridement procedures with glycine air polishing. Virtual Meetings can be a great experience! Now, everyone knows that each patient varies and so do circumstances in the schedule from day to day. Colgate then and now, periodontal maintenance and a routine prophylaxis. 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. 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. Start pairing patients and insurance codes more effectively to move from standardized care to person D4910 Perio Maintenance Full Mouth Probe Intraoral photos D9630 Perio Gel Trays 1-2x/day for 15 minutes* * Patients with severe periodontitis may need to continue 2x/day in maintenance. Retrieved from, Position Paper: Periodontal Maintenance. D4910 is a dental code that can cause confusion. Our goal as clinicians is to decrease periodontal bacteria that causes inflammation and maintain periodontal health. The bottom line is that periodontal maintenance treats active disease, while a prophylaxis is preventative. 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. This long-term employment with periodontists allowed me to see the best and worst of periodontal disease and how to treat it. 14. However, some Medi-Cal adult Periodontal disease—literally, disease “around the tooth” - affects the gums and the bone to which a tooth is attached. Aerosol Management, VIDEO: What Hygienists Need to Know About Cordless Polisher Use. Regular teeth cleanings are actually called prophylaxis in the dental world. 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. Of course, I always tell people that following is a periodontal procedure; we should be doing periodontal maintenance, D4910. Patients who require D4910 follow-up care should receive as many per year as advised for appropriate treatment, regardless of insurance coverage. However, improving your reimbursement for Periodontal Maintenance doesn’t have to feel like an uphill battle. Her mission is to help hygienists and their practices develop a hygiene department that delivers cutting edge and lifesaving care to patients. Evaluate your perio maintenance patient with accurate data and compare the findings from 1, 2, or 3 years past. Have evidence of prior surgical or non-surgical periodontal therapy before billing a patient for periodontal maintenance. All Adults: Created Date: 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. o When submitting your first claim for a D4910 to MetLife, please have your attending Dentist provide Many patients resist regular periodontal maintenance visits after a definitive periodontal scaling. What are the changes? It includes removal of bacterial plaque, calculus, from supra and sub-regions, and SITE specific SRP where indicated, as well as polishing the teeth1. 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. The periodic evaluation (D0120) or D0180 is submitted as a separate procedure on the same date of service. 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. 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. 2. She believes if practice members individually and collectively commit to continual improvement, then clinical excellence will be the natural outcome. Coding should not be dependent on what insurance covers but instead should be based on the individual's actual treatment. 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 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. We now know that the inflammatory burden that stems from oral infection can have a relative effect on systemic health such as diabetes, RA, and vascular disease. 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. 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. On a personal note, her free time is spent on the beaches of the Crystal Coast of NC, most often on horseback. © 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. Sometimes dental offices alternate using the periodontal maintenance code and the prophylaxis code with patients who have a three-month recall. 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. 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. One additional cleaning and one additional exam per year. This code includes removal of bacterial plaque and calculus from supragingival and subgingival areas, along with site-specific scaling and root planing. It is our responsibility to provide resources to assist them in having good oral hygiene and more effective daily routines. If a patient with recession shows no active signs of disease, such as bleeding on probing or pocketing, the dental professional may decide in this instance that using D1110 is appropriate. Added on Sunday, January 01, 1984 Status changed on Wednesday, January 01, 2003 to: No maintenance for this code Otherwise, finding a history may be a challenge. 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