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Prophy to PMT w/ out SRP?

I am new at my current office and I took over for a hygienist that retired. Lately I have been noticing that there have been several patients that she converted from prophy to perio maintenance without ever doing SRPs! They were not done at other offices (we make notes of that when it happebs), they just never had SRPs and went straight from prophy to maintenance! There are no chart notes explaining the change and inbsone cases the change was a year or more ago. Has anyone had a similar experience? And how would you even handle this?



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2 Answers

I had to get a second opinion from one of my friends Emily Boge. Here’s what she said:

As for the question on the table, I generally approach coding situations like I would want them approached if I were the person who made the “error”. That being said, the first step is to discuss the problem with the practice owner. The practice owner is accountable for any third party payment issue, and the main way the “new” RDH could get in “trouble” is by ignoring the error after becoming aware of it. Once she reports the error to the practice owner verbally and in writing (I put it this way because I am unaware if of his practice is corporately owned) if the business chooses to ignore it, the problem is out of her hands. As hygienists we are are not accountable for coding we did not enter or state on the router.

I would recommend reevaluating these patients and deciding whether to do perio therapy (even on one tooth with a decreased 4342 fee) with 4910 follow-ups, or place on 1110. I would explain to the patient that one hygienist cannot make comments on work she or he did not code and complete.

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Hmmm, did insurance cover this? Is there clinical evidence that Perio treatment is needed? If they do need Perio, I would continue with current plan and add SRP if needed. If insurance is not paying, I would reevaluate and go from there.

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