![]() Periodontal charting should be dated no more than 12 months before the date of service. ![]() The D4341 and D4342 procedures require you to submit periodontal charting that indicates at least Case Type II periodontal disease (4-6mm pockets, early bone loss). Inadequate periodontal charting or x-rays However, you’re expected to know the policy upon payment.ĭenial code: 447. No more than two quadrants of scaling and root planing are allowable on the same date of service. The reason for performing more than two quadrants on the same date of serviceįour quadrants of SRP may be approved on a pre-authorization when criteria are met.Information about the local anesthetic used.Evidence of length of appointment (successful scaling typically takes 30-45 minutes per quadrant with local anesthesia).Acceptable supporting documentation includes: Without supporting documentation, the fees for more than two quadrants of SRP performed on the same date of service are not billable to the patient. Submission of more than two quads of SRP on the same date of service Without a reduction in the alveolar crest level, root planing isn’t achievable.ĭenial code: 5F8. Submitted documentation fails to support payment of benefits for scaling and root planing.Exposure of cemental surfaces of the roots is necessary for root planing.In addition to qualifying pocketing, radiographs must show loss of alveolar crest height beyond the normal 1-1.5mm distance to the cemento-enamel junction (CEJ).When fewer than four diseased teeth are involved, Delta Dental bases its allowances on procedure D4342.Claims for periodontal scaling and root planing (D4341 and D4342) are denied more frequently than those for many other procedures, according to the American Dental Association.ĭelta Dental defines periodontal scaling and root planing (SRP) as “a definitive non-surgical periodontal treatment involving the judicious and thorough planing of the root surface.” The procedure involves instrumentation of the crown and root surfaces of the teeth to remove plaque and calculus.Īlthough you should always refer to the Delta Dental Dentist Handbook for specific processing policies and guidelines, we’ll highlight some common reasons for denials for SRP and associated procedures.ĭocumentation fails to support payment of SRPĭelta Dental considers a quadrant of procedure D4341 to consist of at least four diseased teeth (4-6mm pockets, early bone loss). ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |