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Code D4346

Just curious as to how many hygienists are using the code D4346( generalized moderate to severe gingival inflammation with no attachment or bone loss)? How are the insurance companies paying for this service and also do full mouth probe depths need to be sent along with the claim?



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2 Answers

D4346 doesn’t become effective until January 1, 2017. It may take a few additional months for insurance companies to recognize this code and offer coverage. As far as documentation, a perio chart showing pseudopockets and bleeding points and intraoral photos or radiographs may be required. Here is a good link from the ADA about the new code that may be helpful to you: http://www.ada.org/~/media/ADA/Publications/Files/D4346EducationGuidelines_Final2016May17.pdf?la=en

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I don’t come across many patients that fit the criteria for D4346. My hope is that hygienists don’t misuse this code to placate the dentist. If NSPT is indicated, it should be diagnosed and provided.

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