CDC Periodontal Procedures Coding 3

Question 1

Which CDT code added in recent CDT editions describes scaling in the presence of generalized moderate or severe gingival inflammation — full mouth?

Accepted Answer

D4346

Answer

D4346 was introduced to capture scaling performed when generalized moderate or severe gingival inflammation is present but the patient does not meet criteria for SRP (no bone loss).

Question 2

What documentation is typically required by insurers when submitting a claim for periodontal scaling and root planing (D4341/D4342)?

Accepted Answer

Periodontal probing depths, radiographic evidence of bone loss, and a description of clinical findings

Answer

Claims for SRP require supporting documentation including periodontal charting with probing depths, radiographs demonstrating bone loss, and narrative clinical findings to establish medical necessity.

Question 3

A patient completed full mouth scaling and root planing six months ago and returns for a supportive care visit. Which code should be reported?

Accepted Answer

D4910

Answer

Once a patient has undergone active periodontal therapy, all subsequent supportive cleaning appointments are reported as D4910 (periodontal maintenance), not D1110.

Question 4

What is the most common insurance-allowed frequency for periodontal maintenance (D4910) per year?

Accepted Answer

Every 3 to 4 months (three to four times per year)

Answer

Most dental insurance plans allow D4910 up to three or four times per year (every 3–4 months), reflecting the clinical recommendation for supportive periodontal therapy intervals.

Question 5

What information must typically be included when submitting a claim for osseous surgery (D4260)?

Accepted Answer

Quadrant, tooth numbers, radiographic evidence of bone loss, and periodontal probing documentation

Answer

Insurance claims for osseous surgery require the quadrant treated, specific tooth numbers, radiographic evidence of osseous defects, and periodontal probing records to support medical necessity.

(CDC) Certified Dental Coder Practice Test

(CDC) Certified Dental Coder Practice Test

CDC Periodontal Procedures Coding 3