You know the routine – you grab your big-gun power scaler and knock off all the gross deposits. Any claim submitted electronically or on paper must use procedure codes from the current version of the CDT manual. I am looking for documentation to present to my dentist that D4355 (gross debridement) isn’t considered standard of care. And it just might be during the initial comprehensive exam, the dentist determines the patient needs a full mouth debridement. Dental coding can cause a lot of headaches in dental practices. D4355 will be denied when performed on the same date of service as D0120. Diagnosis Codes Current Dental Terminology Codes. Some procedure code entries also have descriptors printed in regular typeface. You will need to check with each individual carrier for sepecific guidelines, general rule of thumb do not bill an exam on the same day as a debridement. D4355 is performed before the subsequent comprehensive evaluation simply to remove gross deposits from the tooth surface. This office is concerned about the 36-month wait required between a D0150 and full mouth debridement. Description According to the American Dental Association (ADA), the dental procedure code D4346 is defined as, "scaling in presence of generalized moderate or severe gingival inflammation – full mouth, after oral evaluation. CDT Code Description D4355 Full mouth debridement to enable a comprehensive oral evaluatoi n and diagnossi on a subsequent visit CDT ... American Dental Association (ADA); CDT 2020 Dental Procedure Code Book. As you can see, these procedure codes all start with a “D4”. The full mouth debridement code (D4355) should never be reported on every new patient, but only as indicated. D1110, D1120, D4910, D4341, D4342 and D4346 will be denied when performed on the same date of service as D4355. Asked By: Kees Kohlmeier | Last Updated: 4th April, 2020. CODING WITH CONFIDENCE Dramatically Cut Coding Errors and Boost Legitimate Reimbursement It's actually fun in a macabre sort of way. Most carriers want the debridement D4355 performed on a seperate day from the exam. Dental Code. - Code D4355 is not a replacement code for D4345-Periodontal Scaling Performed in the Presence of Gingival Inflammation. The current description for this code is, "A dental prophylaxis performed on transitional or permanent dentition that includes scaling and/or polishing procedures to remove coronal plaque, calculus, and stains." The dentist must change the course of treatment. Do I use the Gingivitis code D4366 or just fight through a Prophylaxis with the D1110 code and write a narrative explaining the increased price? Both are inappropriate because they are not codes that accurately describe the service actually rendered. Code D4345 was deleted in 1995, but it still may be paid by certain insurance plans, despite the fact that it is not a current ADA code. D4355 Full mouth debridement to enable comprehensive periodontal evaluation 220 90 130 D4910 Periodontal maintenance procedure following active therapy 144 75 69 PROSTHODONTICS D5110 Complete dentures - upper 1709 655* 1054 D5120 Complete dentures – lower 1709 605* 1104 D5130 Immediate denture - upper 1175 683* 492 D5140 Immediate denture - lower 995 605* 390 D5213 … In my reference book, the “Dental Insurance Coding Handbook” - updated for the ADA CDT-2005 - a D4355-Full Mouth Debridement to Enable Comprehensive Evaluation and Diagnosis is described by the ADA as: “The gross removal of plaque and calculus that interfere with the ability of the dentist to perform a comprehensive oral evaluation. Listing of a code in this guideline does not imply that the service described by the code is a covered or noncovered health service. D4355 – Full-Mouth Debridement *****Again, this is a general list of perio codes to reference! D4355 - CDT® Dental Code CDT (dental or "D") codes and related material here. Because the comprehensive exam is impossible today. CDT 2016. and revised in . This procedure Code D4355 is a full mouth debridement to enable a comprehensive oral evaluation and diagnosis on a subsequent visit. A procedure code entry consists of the code with its nomenclature, which are printed in boldface type. dentistryiq.com. Any feedback would be appreciated. The code D4355 Debridement is performed when an exam cannot be performed due to poor oral health. Why Do We Need Dental Codes? These are sample pages of the book containing front and back cover, table of contents, explanation of legends, sample full mouth debridement (D4355) code, and index Charles Blair, D.D.S. CDT 2018. The problem can occur when a patient presents for a new patient exam and x-rays. The D4355 code states, “the gross removal of plaque and calculus that interfere with the ability of the dentist to perform a comprehensive oral evaluation. Procedure code D4355 requires PA when performed on children through the age of 12. D0145, D0150, D0160 and D0180 will be denied when performed on the same date of service as D4355. CDT Nomenclature: Scaling in presence of generalized moderate or severe gingival inflammation – full mouth, after oral evaluation. Access to this feature is available in the following products: ADA CDT® Codes (Dental "D" Codes) If billed in conjunction with any other dental exam, the exam must be medically necessary, and documentation must support the service. 33 Votes) The CDT heading and descriptor for D4355 is: Full Mouth Debridement to Enable Comprehensive Evaluation and Diagnosis. CDT codes that fall under hygiene treatments are often related to radiographs, chemotherapeutics, sealants, fluoride and more. Current And Past Dental Terminology For D4246. Debridement is defined by CDT code D4355, whose "descriptor", or definition, is: “The gross removal of plaque and calculus that interfere with the ability of the dentist to perform a comprehensive oral evaluation. Dental insurance codes that are perio codes, start with this “D4”. Dental coding can cause a lot of headaches in dental practices. Most common D4345 code reviews : Typical crown benefits for the replacement of an existing crown range from five to seven years before a replacement crown payment will be permitted, Laboratory processing of microbial specimen to include culture and sensitivity studies, preparation and ransmission or written report or Deep sedation/general anesthesia - each additional 15 minutes.