Periodontics

D4342: Periodontal Scaling and Root Planing - One to Three Teeth Per Quadrant

Scaling and root planing when there are one to three teeth per quadrant with periodontal disease.

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When to use D4342

Localized periodontal disease

When only one to three teeth in a quadrant have clinical attachment loss, pocket depths of 4mm or greater, and radiographic bone loss.

Partial quadrant treatment

Some quadrants may have a mix of healthy sites and diseased sites, with only a few teeth requiring SRP.

Common D4342 denials

These are the denial reasons we see most often for D4342. Each one is preventable with proper documentation.

⚠ Insufficient probing depths

If perio charting doesn't show pockets of 4mm+ on the teeth billed, the claim is denied. Full-mouth probing depths must be documented.

⚠ Billed same day as D1110

Prophylaxis and SRP on the same date is a contradiction. A patient either needs a cleaning or needs SRP, not both.

⚠ D4341 vs D4342 confusion

D4341 is for four or more teeth per quadrant. D4342 is for one to three teeth. Using the wrong code triggers a denial.

Documentation checklist for D4342

Full perio charting

Six-point probing depths for all teeth, recorded before treatment.

Teeth treated

List the specific teeth that received SRP in each quadrant.

Radiographic bone loss

Radiographs showing bone loss around the affected teeth.

Bleeding on probing

Document BOP at the affected sites.

D4342 vs D4341: Tooth count matters

The code is determined by how many teeth in the quadrant have periodontal disease. D4342 is for one to three teeth per quadrant. D4341 is for four or more teeth per quadrant. Count only the teeth with clinical evidence of periodontal disease (pocketing, attachment loss, bone loss), not all teeth in the quadrant.

If a quadrant has six teeth but only two of them have 5mm+ pockets with bone loss, the correct code is D4342. If five of the six teeth are involved, the correct code is D4341. Inaccurate tooth counts are a leading cause of SRP claim denials.

Supporting documentation for SRP claims

SRP claims require more documentation than most dental procedures. At minimum, payers expect: full-mouth probing depths (six points per tooth), radiographs showing bone loss, a periodontal diagnosis, and identification of the specific teeth treated in each quadrant. Without all of these elements, claims are routinely denied or downgraded to a prophylaxis fee.

Related codes

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