Monday, January 30, 2017

WELCOME CDT CODE ADDITION BEGINS JANUARY 1, 2017
In March each year, the Council on Dental Benefit Programs Code Maintenance Committee meets to add, delete, or modify CDT codes, most often following suggestions submitted by ADA members during the previous year. One of the most requested additions in March 2016 was a new scaling code: D4346—Scaling in the Generalized Presence of Moderate or Severe Gingival Inflammation—Full Mouth After Oral Evaluation can be used after January 1, 2017.

The Chairman of the Code Committee describes D4346 as “more than a prophylaxis because the clinical condition of the patient’s gingiva is compromised as evident by the level of inflammation, but less extensive and intrusive than scaling and root planning since there is no bone or attachment loss.”
Coverage for the procedure will vary according to the benefit plan and the payer. Some payers may have frequency limits, and it is predicted that benefit companies will closely monitor utilization of this code. Reimbursement is expected to be in a range between prophylaxis and scaling and root planing.

For more information on this and other changes to the CDT 2017, visit www.ADA.org/en/publications/cdt/coding-education. Search for “Guidance on the D4346 Scaling Procedure.” Dr. Charles Blair’s excellent annual publication, Coding With Confidence: The “Go To” Dental Guide, is ready for sale online at Practicon.com or by phone at 800-959-9505. Dr. Blair’s Guide includes, of course, the new D4346 code with full explanation. Regular use of his Guide assures your staff will eliminate coding errors and boost legitimate reimbursement.

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