Insiders Q+A

We have been taught that once someone is perio maintenance they are always perio maintenance and can’t switch from perio maintenance to prophy, but…

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Question: We have been taught that once someone is perio maintenance they are always perio maintenance and can’t switch from perio maintenance to prophy. However, recently we are finding insurance companies are telling us to bill perio maintenance then prophy then perio maintenance then prophy in order to see them every 3 months. What is your knowledge on this?

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D4346 Code Q+A

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1. Is dental insurance paying for this procedure yet?
2. As a norm, does the appointment last one hour or over several appointments, similar to scaling and root planing?
3. Can we use the adult prophylaxis code directly after (say if the 4346 code is valid for 1 appt, could adult prophy follow it a week or so later, or does it need to be several months from it?)

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Evaluation Code with D4910

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The issue has to do with D0150 and D0180 and the use of D04910. We understand scenarios of D0120 with D4910, and D0180 and D4910. The question has to do with D150 and D4910. We could see a scenario where a perio pt returns after a three year absence from our practice and presents as periodontally stable. Would we be justified using D0150 with a D4910?

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