There is a new gingivitis code in 2017.

Thhe new gingivitis code is intended for patients who have moderate to severe gingivitis, inflammation and yet they do not have any signs of radiographic bone loss; no periodontitis.

Why was the procedure for “scaling in the presence of…generalized gingival inflammation” assigned a code in the CDT Code’s “D4000’s” (Periodontics) category rather than in “D1000’s (Preventive)?

Currently we have a code for healthy periodontium (D1110), codes for non-surgical periodontal therapy (D4341/D4342), a code for the maintenance of periodontally-involved patients who have undergone non-surgical periodontal therapy (D4910), and a code for gross-debridement (D4355).

We have never had a code to support insurance billing for a patient who does not fall into any of the above categories. The CMC has typically decided that gingival disease treatment should be coded using D1110 yet for many this has never made much sense.

The New Gingivitis Code 2017 is: D4346

WHAT YOU NEED TO KNOW:

The procedure is considered therapeutic for a patient in a diseased state, as noted by the following sentence in the D4346 descriptor – “It is indicated for patients who have swollen, inflamed gingiva, generalized suprabony pockets, and moderate to severe bleeding on probing.”

When a patient is diagnosed with generalized gingivitis following an oral evaluation this scaling procedure treats the generalized gingival inflammation and pseudopockets present.

In our next blog I will answer why it’s important that hygienists understand how to use this new code.