Utilizing Perio Code D4346 Effectively

Starting with the CDT code update in 2017, a new perio code was created: D4346.  This code is for scaling in the presence of generalized moderate or severe gingival inflammation.  Just because there is a new code does not mean that hygiene teams know how to utilize it.  How effective is your hygiene team at using this procedure?

One challenge faced by hygiene teams is understanding when to use D4346.  The purpose of D4346 is to achieve healthy gum tissue for patients who have not crossed the line into having gum disease.  You would not report D4346 in conjunction with scaling and root planing or a periodontal maintenance.  You would also not report this procedure with a regular cleaning.  Patients who need the procedure do not have gum disease; however, these patients need more than a regular cleaning due to moderate to severe inflammation.  The dentist needs to make the final determination for D4346—the code indicates the procedure follows an oral evaluation.

Now there is a therapeutic code to treat patients who are in between gum disease and gingivitis.  Hygiene teams have another tool for treating patients.  In most cases, patients who receive a D4346 will return to a regular cleaning and six month recalls, assuming home care improves. 

To improve the odds of having the procedure covered by insurance, include a narrative explaining that the patient has generalized moderate or severe inflammation.  Include full periodontal charting as well.

Make sure your dental team is utilizing D4346 as needed.  Review your hygiene and perio protocols to ensure you provide the appropriate treatment for patients who need more than a cleaning but who do not need perio therapy.

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