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

Please confirm that you would like to report this for an admin to review.


4342 recall

I am in WA state, does anyone know how “most” insurance plans reinburst with Perio Maint. on 4342 1-3 teeth SRP? I read must be a class 3 or above a lot, but not sure if it has to be atleast a quad(4341) or if they will allow more cleanings for 4342 as well.

With that in mind, do you consider 4342 a perio maint. patient, even if it was only two 5mm pkts in one area??



Confirm that you would like to Remove Email Alerts for your question. You cant undo this and you will not be able to re-subscribe.


Tags

2 Answers

After any Perio code for S/RP is used the pt should be coded 4910. Once Perio…….always Perio. Are you also charting attachment loss? If a pt has 5mm on #2 and #19 and you selectively S/RP the pt more than likely has other areas of attachment loss. AL added with PD is the big picture of the destruction of the bone and supporting structures. Just because a pt only has two 5mm pockets doesn’t mean that other areas that have 3mm probing depth is healthy when the pt also has 5mm recession…….that’s 8mm of attachment loss.

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


I have found most insurance only pays for perio maint twice a year regardless if they had a 1-3 or full quad SRP. Very few will pay for more than twice a year. Also found that insurances will only consider a pt perio maint if you provided 1-3 SRP in more than one quad. So if you only had 1-3 in the UR some may not consider the pt perio maint. In that case insurance would pay for only an adult prophy and a limited 1-3 SRP in the UR.

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


You must be Logged In to Answer this Question

Already a Member, Log In
Not a member yet? Sign Up

Search

Categories

Like Kara RDH on Facebook!