You are confused between prophy code and perio maintenance code. If you did a SRP and on 3 months recall for cleaning (perio maintenance code gonna be billed instead of prophy).
Basically routine 2 times per year covered is D1110. After the SRP, your 3 months service would be filed as D4910. Check your insurance on how they cover that code.
Running a dental clinic is extremely expensive, you wouldn't find places charging $50-$60 per cleaning anymore, even if you do, I would be very skeptical they doing good work...
> So what is the actual difference between prophylaxis and periodontal maintenance? The answer is simply determined by confirming what was actually done on behalf of the doctor’s diagnosis. Was it only scaling? Was it scaling and polishing? What and where was root planed? It is here that the actual definitions from Current Dental Terminology will be helpful.
>D1110 prophylaxis – adult
Removal of plaque, calculus and stains from the tooth structures in the permanent and transitional dentition. It is intended to control local irritational factors.
>D4910 periodontal maintenance
This procedure is instituted following periodontal therapy and continues at varying intervals, determined by the clinical evaluation of the dentist, for the life of the dentition or any implant replacements. It includes removal of the bacterial plaque and calculus from supragingival and subgingival regions, site specific scaling and root planing where indicated, and polishing the teeth. If new or recurring periodontal disease appears, additional diagnostic and treatment procedures must be considered.
RozenKristal t1_j5uue3d wrote
Reply to Dental Insurance which covers 4 cleaning per year? by aleshere
You are confused between prophy code and perio maintenance code. If you did a SRP and on 3 months recall for cleaning (perio maintenance code gonna be billed instead of prophy).
Basically routine 2 times per year covered is D1110. After the SRP, your 3 months service would be filed as D4910. Check your insurance on how they cover that code.
Running a dental clinic is extremely expensive, you wouldn't find places charging $50-$60 per cleaning anymore, even if you do, I would be very skeptical they doing good work...
> So what is the actual difference between prophylaxis and periodontal maintenance? The answer is simply determined by confirming what was actually done on behalf of the doctor’s diagnosis. Was it only scaling? Was it scaling and polishing? What and where was root planed? It is here that the actual definitions from Current Dental Terminology will be helpful.
>D1110 prophylaxis – adult Removal of plaque, calculus and stains from the tooth structures in the permanent and transitional dentition. It is intended to control local irritational factors.
>D4910 periodontal maintenance This procedure is instituted following periodontal therapy and continues at varying intervals, determined by the clinical evaluation of the dentist, for the life of the dentition or any implant replacements. It includes removal of the bacterial plaque and calculus from supragingival and subgingival regions, site specific scaling and root planing where indicated, and polishing the teeth. If new or recurring periodontal disease appears, additional diagnostic and treatment procedures must be considered.