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    Understanding gingival inflammation code D4346

    Clearing the fog of confusion surrounding this vital code.

    Foggy weather is common in the spring. You wake up, look out the window and know that traffic will be a mess. Your hope is for the fog to lift and the sunshine to break through before you have to get in your car.

    For the dental industry, a fog seems to have settled around the new D4346 gingival inflammation code. For many, it’s a code we hoped for and knew was needed for a long time. Yet there is a lot confusion and our understanding is foggy.

    I want to clear up some of the fog surrounding this code. Breaking through the fog will reveal specific reasons for patients to return to your practice, thus escalating its profitability.

    Related reading: 5 important facts about new code D4346

    Eight points to understand

    As an invited author in the CDT 2017 Companion book, I learned the details of D4346 back in March 2016. I was excited by the opportunities, yet knew it would take shifts in our traditional thinking about treating gingival disease.

    To set the table, the new code including the description reads:

    "D4346 scaling in presence of generalized moderate or severe gingival inflammation—full mouth, after oral evaluation. The removal of plaque, calculus and stains from supra- and subgingival tooth surfaces when there is generalized moderate or severe gingival inflammation in the absence of periodontitis. It is indicated for patients who have swollen, inflamed gingiva, generalized suprabony pockets, and moderate to severe bleeding on probing. Should not be reported in conjunction with prophylaxis, scaling and root planing, or debridement procedures."

    The ADA created a Guide to Reporting D4346. However, I saw this would only be a starting point for a major shift.

    My book, A Gingivitis Code Finally! came out in September 2016. I broke D4346 down into digestible pieces, using mini-quizzes, case histories and more to give you what you need to successfully and profitability implement this new code.

    More from the author: The truth about alternating codes D4910 and D1110

    As I have traveled the country speaking, I determined there are eight major points to grasp to blow away the fog surrounding the D4346 code:

    1.    Care is therapeutic not preventive.

    2.    An oral evaluation must be completed before care.

    3.    This code is not age-based.

    4.    All patients must have a periodontal chart and current radiographs (including children) to show the absence of periodontitis.

    5.    Documented type 2-3 on the Löe and Silness gingival inflammation index must be > 30 percent of the teeth (e.g. 30 teeth then >10 teeth.)

    6.    A specific periodontal diagnosis must be documented. (Every case qualifying for D4346 is not plaque-induced gingivitis.)

    7.    Care is for the full mouth. No other scaling codes can be submitted on the same date.

    8.    D4910 does not follow this care


    Continue to page two for FAQs about D4346...

    Patti DiGangi, RDH, BS
    Patti DiGangi, RDH, BS is a certified Health Information Technology trainer through the Office of the National Coordinator for ...


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