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Dental coding with Kyle: Provisional splinting

Feb. 14, 2019
Dental coding is tricky sometimes. That's why it's important to get it right and receive reimbursement for your practice.
Kyle L. Summerford, Editorial Director
D4320—Provisional splinting, intracoronal

D4321—Provisional splinting, extracoronal

The purpose of provisional splinting is to stabilize mobile (loose) teeth and maintain them in the position before periodontal surgery due to bone loss.

The teeth are cleaned and isolated, no anesthesia is typically used, but in some cases the teeth will be cut and anesthesia must be used. There are different types of splinting materials, with the most common being metal wire or braided fibers. The “wire” is then placed along the teeth and bonded and cured.

There are many variables involved when it comes to dental insurance coverage and reimbursement.

• Dental insurance companies will usually only cover “permanent” procedures, and according to insurance companies a splint is considered a temporary prosthesis.

• If bone loss is visible on x-rays, the dental insurance company may suggest the treatment is unnecessary in order to avoid paying for it. The company may provide benefits toward a tooth extraction instead.

• Submitting a clear written narrative that explains the benefits of splinting, and outlining the treatment plan with the desired prognosis, can help facilitate approval in some cases.

• Providing x-rays, narrative, recent periodontal charting, and photographs will ensure a smooth claims process.

It is very important for you to remember this: Even though the insurance company may not pay for a particular procedure, this does not mean that the insurance company’s decision is in the best interest of the patient.

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Kyle L. Summerford is a nationally recognized practice management guru, author, and lecturer. He is founder and president of Summerford Solutions Inc., and cofounder of Elitedentalclaims.com. Kyle also serves as editorial director of Pennwell's Dental Office Manager Digest e-newsletter. He lectures extensively to dentists and their staff on topics such as insurance coding and billing and useful practice management tips. Contact him at [email protected].

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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].