Updating Periodontal Charting

This is a common question many clinicians have. There is no ADA code describing updating periodontal charting as a separate procedure. The ADA does have code 0180 for a Comprehensive Periodontal Evaluation and a clinician may bill for this procedure as indicated. Since it is a diagnostic code, if the dental hygienist performs the periodontal charting, the dentist still must examine the patient for a diagnosis. The ADA description of 0180 states that “this procedure is indicated for patients showing signs or symptoms of periodontal disease and for patients with risk factors such as smoking or diabetes. It includes evaluation of periodontal conditions, probing and charting, evaluation and recording of the patient’s dental and medical history and general health assessment. It may include the evaluation and recording of dental careis, missing or unerupted teeth, restorations, occlusal relationships and oral cancer evaluation.” Depending upon the clinical conditions of the patient you may provide a 0180 Comprehensive Periodontal Evaluation that includes probing and charting on a Periodontal Maintenance patient and bill appropriately, or you may include that service with the Periodontal Maintenance procedure itself. Insurance reimbursement varies with use of the 0180 procedure code. 04999 Unspecified Periodontal Procedure could be used to describe periodontal charting and billed separately; but this code requires a narrative or report to describe specific use of this code. Insurance reimbursement is generally not provided with use of 04999 code.