Altering a Patients Coding Without Charging for SRP 1st?

A great resource worth investing in is “Coding with Confidence” by Charles Blair. You can view a sample of it at: www.drcharlesblair.com. I have used this reference for years to assist in maximizing patient’s benefits. The situation you refer to in your practice is not necessarily uncommon. Decreasing a patient’s interval may be helpful in reducing the amount of biofilm and local factors present in the oral environment, but is no substitute for an accurate diagnosis and therapeutic intervention. The answer to your question is: No you cannot move from D1110 to D4910 without first making a diagnosis and providing appropriate definitive therapy. The ADA definition of periodontal maintenance states that is begins “following periodontal therapy." There is no appropriate way to bill out D4910 without prior scaling and root planing or osseous surgery. From your description, it sounds like these patients with 4mm+ should be accurately assessed for active periodontal infection, and when present, be treated with nonsurgical and/or surgical treatment, as indicated. Following that protocol, D4910-Periodontal Maintenance would be indicated. It is great that you are concerned enough to want to provide appropriately billed procedures. Best to you. KAREN DAVIS, RDH, BSDH