QUESTION: I see that we have a new code D4921 for periodontal irrigation. Is it being reimbursed by insurance companies?
ANSWER: This code was a welcome addition for many offices who previously charged D4999 to report the use of antibacterial or antimicrobial irrigation along with periodontal surgical procedures. The code is reported by quadrant use. Clients and audience members are reporting that although they are billing it, the amount of reimbursement is negligible. Delta Dental of most states is not reimbursing for it and is requiring the charges to be written off. In those cases it is considered part of the primary procedure (much like pulp caps for fillings). Assess the charge if applicable but always let the patient know that it may not be covered.
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Teresa Duncan, MS, FADIA, FAADOM, is an international speaker who addresses topics such as insurance coding, office manager training, and revenue growth. Her company Odyssey Management, Inc. provides virtual, customized training in these areas. She can be reached at [email protected]. Inquire today about Odyssey’s Billing & Coding ESupport program!
