Coding with Kyle: Code 4346 still causing confusion
Still confused about that new code D4346? Let’s do a quick review and get this settled once and for all.
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D4346: Scaling in the presence of generalized moderate or severe gingival inflammation, full mouth, after oral evaluation
The purpose of the code is to achieve healthy periodontal tissue after the initial examination.
This code should not be reported in conjunction with scaling and root planing (SRP), prophylaxis, or any periodontal maintenance cleanings. By submitting this procedure for payment, you are reporting that the patient is not a candidate for a simple prophylaxis and is not a candidate for SRP, and therefore the patient needs a more specific “cleanup” due to moderate to severe inflamed tissue.
Related: SRP Insurance Narrative Template for Dental Office Managers – Streamline Claims
Supporting narrative and documentation
A brief narrative, along with periodontal charting that indicates pocket depths, inflammation, bleeding on probing, and loss of attachment, should be included with this claim. The wording for diagnosis should indicate “generalized moderate or severe inflammation.”
Be sure to always submit pre-op and post-op (if available) radiographs.
Happy coding!
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