Over the last few years, new research has broadened our understanding of the implications of gum disease. As the connection between oral bacteria and inflammation, and overall health has become clear, there has been an increased emphasis on treating gingivitis to help patients avoid a further decline into periodontal disease. Unfortunately coding has failed to reflect this new understanding and the coding gap that exists between healthy patients and those diagnosed with periodontal disease has made gingivitis intervention difficult.
Consider how you address gingivitis in your practice. Typically these patients are treated with a prophy and education on improving homecare. For many this will not be sufficient to reduce gum inflammation, and gingivitis will eventually progress to periodontal disease.
“Current codes document treatment procedures for patients with a healthy periodontium or patients with periodontal disease that has accompanying loss of attachment — such as periodontal pockets and bone loss,” said Dr. Ronald Riggins, committee chair. “However, there is no CDT code available to record therapeutic treatment of patients with gingival disease and no attachment loss.”
In March, the Code Maintenance Committee approved a new scaling code designed to address this coding gap and represent care for patients with gingival disease, without attachment loss. The new code, which will appear in the periodontics category of the 2017 CDT manual, is defined as “scaling in the generalized presence of moderate or severe gingival inflammation — full mouth, after oral evaluation.”
This new code allows the dental team to properly document the treatment needed, both for the patient and a third-party payer. While there is no guarantee that insurance companies/employers will provide coverage for this treatment, proper documentation for the necessary care is a step in the right direction! For help explaining the importance of gum health to your patients, request a complimentary copy of the Total Health patient brochure from your Henry Schein representative.