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Coding with Kyle: 2022 periodontal scaling updates

March 17, 2022
This column from Kyle Summerford is designed to guide office managers through the tricky world of dental coding. This month he covers updates to codes related to periodontal scaling.
Kyle L. Summerford, Editorial Director

D4341: Periodontal scaling and root planing (SCRP) four or more teeth, per quad

D4342: Periodontal scaling and root planing (SCRP) one to three teeth, per quad

To facilitate dental claim approval, you must make sure your patient meets the insurance plan guidelines prior to performing the treatment and when submitting the dental claim for reimbursement.

More Coding with Kyle: 

SCRP involves the removal of plaque and calculus from the root surfaces of the teeth usually under local anesthesia. It's not the same as a full-mouth debridement (D4355) or prophylaxis (D1110).

Here are some key factors that facilitate insurance claim approval:

  • Pocket depths greater than four millimeters
  • Supporting documentation with narrative indicating periodontal disease and classification type
  • Periodontal charting indicating loss of attachment/bone loss, bleeding on probing, and pocket depths of 4mm or more
  • The same procedure(s) have not been completed within the last 24 months for most dental PPO plans, when billed to the same dental plan
  • Most dental plans prefer SCRP be completed in two separate visits under local anesthesia (indicate)
  • If SCRP was completed in a one visit/one hour appointment, be sure to indicate why and submit a narrative outlining the reason (e.g., patient tolerance)
  • Radiographs showing bone loss

When submitting the dental claim to your patient’s insurance company, be sure you submit the claim with supportive documentation which indicates the necessity. Proper documentation includes notes in the patient's chart, including periodontal charting (within six months), and a clear indication if any presence of calculus, bleeding on probing, and bone loss. Be sure to include the patient's most recent x-rays (preferably a full-mouth series).

Always keep in mind that it's recommended to send in a pretreatment authorization including radiographs and periodontal charting to ensure a smooth claim determination process.

About the Author

Kyle L. Summerford | Editorial Director

Kyle L. Summerford is president of Summerford Solutions Inc. Being a dental office manager, dental practice consultant, and dental coding educator has enabled him to guide his company to provide services to dental practices and their staffs nationwide. Kyle has lectured at many CE events and academic institutions—Stony Brook University, New York City County Dental Society, and Georgia Regents University. He’s authored many Dental Coding with Kyle articles. He’s the founder of Dental Office Managers Facebook Community and Dental Manager Connect. Contact him at [email protected].