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FMD or Prophy

So since I’ve started at this office I have seen too many FMD patients. Patients that I believe and have assessed to be Adult prophy the doctor is diagnosing as needing an FMD. Patients that come in with heavy supra calculus and moderate/heavy plaque I can understand in order to remove deposits for an accurate diagnosis by doctor but not healthy patients. I don’t hear a lot about FMDs and would really like to get more info before leaving this practice over this issue. And do insurance company’s cover FMDs Thank You!



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1 Answer

By your description, I’d question this too. As you said, if a patient has too much debris, calculus, plaque, material alba, etc. to do an exam, a debridement is appropriate. However, I can’t imagine a patient with healthy tissue (treatment planned as a prophy) needing an FMD. At the very least, a patient with this much debris would need to be treatment planned for gingivitis treatment (D4346) or non-surgical periodontal therapy/SRP (D4341/4342) because infection would be inevitable, generally speaking. Even then, I personally would go straight to definitive treatment (SRP or gingivitis tx) and forego the FMD for many reasons. I feel FMD is an antiquated, overused, and a misused code and procedure. I’ve heard from countless amounts of hygienists, and I’ve come across offices/doctors myself, who treatment plan FMDs just to boost production because patients don’t know any better so they don’t question it. To me, this is unethical and equates to over-treatment. Whether an office/doctor doesn’t understand the code/procedure or is trying to boost production, either way, its unacceptable in my book!
 
Whether insurance covers an FMD depends on the patient’s insurance carrier and specific plan. Many do, but some only cover one FMD per lifetime. Again, it all depends on the specific insurance coverage of the patient. This is why every patient should have an insurance breakdown before even sitting in your chair.
 
I would suggest speaking with the doctor about your concerns and see if you two can get on the same page regarding patient care standard. It is very important that you share the same patient care standard as the doctor. If this cannot happen, it may be time to move on from the practice. Best of luck, this isn’t a fun situation!

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