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

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4342/ 1110

Okay, so say a patient presents with overall healthy probing depths except for a 6mm pocket on the distal of #2. I would normally tx plan this patient for a prophy (1110) with ss srp 1-3 teeth UR (4342). This is how we have always done it, no problems. Well we now have a new OM and he says that I cannot treatment plan these together. He has been taking the prophy code out all together and just leaving the 4342. How would you guys treatment plan this patient? Can I use the 4242 code in conjunction with the 1110 code? And if anyone could direct me towards any literature stating the correct use of these codes in conjunction with one another I would really appreciate it! Thanks!



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4 Answers

I would need to know what is the cause of the pocketing on the distal of #2, is it from a third molar, is there calculus? For a situation like this, I might refer to a periodontist for a gingivectomy. If there is no calculus, it might just need the excess tissue removed so the patient can clean back there more thoroughly. The use of a rubber tip back there to “contour” that tissue can really help. Then, you stick with the 1110 since the patient does not have periodontal disease but a localized perio issue that could be resolved.

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Just recently I have encountered some insurances are not not covering 4342 after a pro unless its 45 days or later.

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I have used these codes together multiple times. However, each ins provider varies on coverage some will not pay at same visit but some will.

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You can’t use those codes together. If the 6mm has bone loss or infrabony defect and you will S/RP selectively then from that point on it is 4910 perio maintenance. IF there is No bone loss and extra tissue that extends up to occlusal surface (CAL) then you can do a debridement (code??) [i consider debridement an Initial Perio Therapy] bring back in 4-6 weeks and re-eval and if looks good then complete a Fine Scale (1110) and polish then place on 3-4-6 month cc interval. You may need to refer to periodontist and they can remove the extra tissue ie: crown lengthening. If the 6mm is truly bone loss etc. You can still do the debridement (initial perio therapy) check in 6-8 weeks for healing and then if still present selective S/RP. You can you those code one after the other but not 1110 and 4342.

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