Cwk 62f2d377b2b86

Coding with Kyle: Gingival irrigation

Aug. 10, 2022
Kyle Summerford helps office managers navigate the tricky world of dental coding. Here he covers D4921: Gingival irrigation—per quadrant.

D4921: Gingival irrigation—per quadrant

This code is used when irrigating a periodontal pocket with a solution such as chlorohexidine (Peridex). By placing the medication directly into the gum pocket, the doctor is targeting the bacteria in the pocket and hoping to reduce the amount of bacteria and alleviate the area of inflammation. Placement usually occurs during a scaling and root planning and/or a full-mouth debridement. 

Submitting the claim with x-rays is not enough to facilitate coverage and payment:

  • This code should be applied only when the procedure involves debridement and/or scaling and root planing.
  • Dental insurance companies will refer to the patient's plan limitations and exclusions when considering the dental claim.
  •  When submitting multiple procedures on the same date of service as D4921: Gingival irrigant, such as D4341/2: Scaling and root planing and/or D4355: Full-mouth debridement, you should report these procedures on a separate claim form, otherwise the entire claim may be rejected and payment denied. 
  • Pre-op and post-op x-rays must always accompany the claim form. In addition, periodontal charting should be included.

A narrative should be included indicating the following:

  • The severity of gingival inflammation
  • The level of sensitivity
  • Bleeding on probing

Happy coding! 

More "Coding with Kyle":

About the Author

Kyle L. Summerford

With more than 22 years of experience in dental, Kyle L. Summerford has a unique approach to case presentation and patient acceptance. As an OM and financial dental consultant, he leverages his knowledge to assist new and struggling dental practices. Through his education programs, Kyle empowers staff members with effective patient education skills and persuasion techniques. He has lectured at CE events and academic institutions. His expertise is further recognized through his column, Dental Coding with Kyle. He’s the founder of the Dental Office Managers Community. Visit his website at