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

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New patients and perio maintenance

I recently started working in a brand new practice. When a new patient comes in and has been on perio maintenance in their old office, has radiographic bone loss, 3 mm pocketing but is not in need of SRP, can I bill out their first visit with me as perio maintenance? I feel like I’m missing a step and not sure what to do.



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3 Answers

Perio maint is the procedure I would bill out as long as they have been on regular maintenance with their previous provider and the bone loss has not increased since they last performed SRP tx. I would request perio charting and radiographs from the previous office to verify. Also if they have new insurance since their last visit, insurance would want these records to verify perio maint was needed versus SRP tx and then perio maint.

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If the new pt is current 3-4 months since last PM you only need the date of original S/RP for insurance purposes. If it has been over 1 year etc they may need S/RP again dependent on the state of active disease.
Even though you don’t need to complete S/RP you still know the history and pt has bone loss and history of S/RP and 3-4 month PM intervals you should bill out 4910.

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That is what I do with new patients if they know they have had SRP in the past, aren’t currently showing active disease (in need of SRP again) and show radiographic signs of bone loss (previous active disease). That, to me, is the definition of a periodontal maintenance patient. Just because my office didn’t do the SRP initially doesn’t mean they aren’t perio maintenance. The history and clinical evidence of past disease needs to be there and if you have that, 4910 it is!

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