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D4346 vs D1110

We are trying to implement the new gingivitis code. However, our dentist is asking what do we do different between a prophy and a prophy in the presence of gingivitis. He is mostly questioning ways to improve our communication with our patients. Help please.



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A prophy is a preventive procedure for a patient who is in a healthy state. Firm, light pink gingiva, no bleeding, etc. The gingivitis code is for a patient who is in a state of gingivitis (infection/inflammation). A patient with gingivitis may have more plaque, calculus, bleeding, pseudopockets, and will need more intensive OHI. The difference is health vs infection.
 
When communicating to patients, you explain this same thing; their gums are infected and must be treated and billed/coded as such because you are obligated to bill/code for procedures/treatment rendered. If your patients ask why they have always had a “regular cleaning” in the past, its because every year the ADA meets to update codes. Previously there wasn’t a code for gingivitis, only health and periodontitis. This code fills that gap so proper billing can be done.
 
Here is a link that explains how to use this code that you may find helpful:
http://www.ada.org/~/media/ADA/Publications/Files/D4346EducationGuidelines_Final2016May17.pdf?la=en

More Answers

The D1110 prophy is only for people who do not show signs of periodontal disease (for example: bone loss, bleeding).

D4346 scaling is for moderate/severe gingivitis.

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