D4346 is a relatively new gingivitis dental code, introduced by the American Dental Association (ADA) for the therapeutic purpose of scaling in presence of gingival inflammation. Before going deeper into the specifications of this dental code, it is imperative to know what exactly ‘Gingivitis’ is.

Gingivitis is an oral disease that refers to the inflammation of gums caused by a buildup of bacteria. Mild gingivitis is indicated by slight edema or change of color while moderate or severe gingivitis is indicated through increased redness, edema, and bleeding on probing. It is a reversible disease and can be cured if sufficient treatments such as the services provided under the dental code d4346 are utilized.

D4346 Dental Code Description

The dental code d4346 was specifically designed for a full mouth procedure which is to be used only if there is a generalized ‘moderate’ or ‘severe’ gingival inflammation with no apparent bone or attachment loss involved. An updated comprehensive oral evaluation, with clear signs of gingivitis, is required before undergoing d4346. It involves removing all deposits that are detrimental to one’s oral hygiene and allows the healing of tissues.

According to the precise definition of ADA, it refers to “The removal of plaque, calculus, and stains from supra- and sub-gingival 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. It should not be reported in conjunction with prophylaxis, scaling and root planing, or debridement procedures.”

D4346 Dental Code Properties

  • Dental code d4346 is a therapeutic service code and not preventative.
  • Full mouth procedure. Not billed for specific areas or quadrants.
  • At least 30% of the mouth must have moderate or severe gingivitis. Not based on the    amount of calculus.
  • It does not have any age limit.
  • It cannot be used in conjunction with prophylaxis (D1110) or Scaling and Root planning (D4341-D4342).
  • D4346 is based on the assessment/diagnosis rather than the intensity of treatment required. This means that even if the treatment required is more difficult and time-consuming than usual, it would still come under d4346 procedural dental code.
  • A periodontal chart is required to show the absence of periodontal disease but instead the presence of Gingivitis only. 
  • Intra-Oral Photographs need to be taken. These will be submitted to the insurance companies for reimbursement claims.
  • To assess healing progress, a follow up appointment needs to be made ideally after 2-3 weeks.

For future examinations, the patient may use D1110 for prophylaxis if healthy, D4346 again if required and D4341/D4342 in case of later bone/attachment loss.

When Not to Use D4346 Dental Code?

Most people often get confused between the dental codes D4346, D1110 and D4341-D4342. In such circumstances when they are unable to differentiate between them, they tend to misuse/underuse or overuse them. Hence, we will try to clarify any possible confusions you may possibly have!

Firstly, it is important to understand why D4346 was introduced in the first place. It was established to fill in the gap between D1110 and D4341-D4342.

D1110 is a preventive dental code aimed at treating localized mild gingivitis to control irritational factors in the patient and improve their overall hygiene through cleaning out deposits.

While D4342-D4342 are used for scaling and root planing in case of gingival inflammation that involves bone or attachment loss, in other words called ‘Periodontitis’.

But what about the cases where there is a presence of moderate or severe gingival inflammation with no bone or attachment loss involved? A dental code for this particular case did not exist previously and thus D4346 was later introduced to cater to this. This new gingivitis code draws a fine line between all these possible cases and their subsequent codes.

Thus, it is very important for you to make sure you know the differences and can claim each code accurately to avoid any misuse.

Required Documentation for D4346 Dental Code

  • A comprehensive oral evaluation that diagnoses generalized moderate or severe gingival inflammation.
  • Periodontal Charting that records bleeding on probing and pseudo-pocket depths.
  • Radiographs to show no bone/attachment loss. Diagnosis ‘Gingivitis’ and not ‘Periodontitis’.
  • Photographs to document Gingiva’s condition (mild/moderate/severe and localized/generalized).

D4346 Dental Code Price?

This is a very common question that most people ask, however, it should be noted that every dental practice clinic holds its very own set of price lists hence, it totally depends on the clinic you’re visiting.

Is D4346 Dental Code Covered by Insurance?

Like other dental codes, most dental plans also cover D4346 however, it is always a better idea to consult your insurance company before starting the treatment to avoid any inconveniences later. Additionally, check if they provide full reimbursements or not considering it’s a relatively new code.

If you’re looking for an efficient, easier to maintain and promising dental billing company in usa, then Zap Dental Billing is a very professional and accommodating choice that is bound to make your life a lot easier. We’ll handle all the appointment scheduling and reimbursement requests while you focus solely on your patient care and services.

Conclusion

For better and accurate dental billing, it is crucial to know and understand the dental codes you’re using such as the D4346 gingivitis code. Its main purpose is to cure moderate to severe gingivitis to prevent it from resulting in bone loss and thus, turning into a periodontal disease. Periodontitis is irreversible and will require surgical treatments hence, it is advised that you stay on a lookout for irritable, swollen and reddish gums with spontaneous bleeding. In such a case, get it treated right away to prevent any complications later and hence, utilize D4346 accordingly.

If you have any further questions regarding dental codes, detailed guides on reimbursements by insurance companies or dental billing, don’t forget to reach us out for help. We would try our best to guide you!