{1 - 24} GreyGrey
{25 - 49} GreenGreen
{50 - 499} BlueBlue
{500 - 4999} OrangeOrange
{5000 - 24999} RedRed
{25000+} BlackBlack

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Perio maintenance

Following srp, if a patient says they cannot pay for a perio maintenance cleaning and only wants what insurance will cover at 100% , do you do a prophy and document why or should you always be perio maint and not do a cleaning at all if pt won’t pay for their portion of the maintenance?



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3 Answers

You can tell them that they have periodontal disease and you have completed S/RP and they are now in a Perio maintenance therapy that requires more frequent hygiene appts and that insurance will cover two a year usually at a percentage and they will pay for one or two out of pocket. They can chose to come in every six months, but it will be coded a 4910 and you will document their non compliance and your recommendations and refer them on to periodontists if necessary.

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If they go through the SRP then you must do 4910. Even with documentation, you would be performing managed neglect.
Always ensure the patient is fully aware of all treatment needed prior to SRP.

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I work for an office that some patients have had S/RP a couple years ago. Since then, they have had prophy’s charged out. What do you guys suggest to discuss with the patient that they are actually having the wrong coded treatment? I know it’s not accurate that the office is doing this but I’ve seen it at other offices as well. It makes it so confusing for patients!!

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