D4910 is for periodontal maintenance following active periodontal therapy. Once a patient has completed scaling and root planing (D4341/D4342), their ongoing recall cleanings should be billed as D4910 instead of D1110. This procedure includes evaluation of periodontal status, removal of bacterial flora from periodontal pockets, supragingival and subgingival cleaning, and assessment of the effectiveness of previous treatment.
D4910 is for periodontal maintenance following active periodontal therapy. Once a patient has completed scaling and root planing (D4341/D4342), their ongoing recall cleanings should be billed as D4910 instead of D1110. This procedure includes evaluation of periodontal status, removal of bacterial flora from periodontal pockets, supragingival and subgingival cleaning, and assessment of the effectiveness of previous treatment.
Do NOT use D4910 for: Patients who have never had periodontal treatment (use D1110 for routine prophylaxis). Active periodontal treatment (use D4341/D4342 for scaling and root planing). Full mouth debridement before evaluation (use D4355).
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Periodontal maintenance for patients who have completed active perio therapy (SRP). Includes periodontal pocket reassessment and subgingival instrumentation.
Routine prophylaxis for patients without periodontal disease history. Preventive cleaning only. No periodontal component.
Payers expect to see D4341/D4342 in the patient's claim history before accepting D4910. If there's no record of prior periodontal treatment, the claim gets denied or downgraded to D1110. Make sure the SRP history is documented and on file with the payer.
Some plans cover D4910 2x per year, others 3-4x. Periodontal patients often need cleanings every 3 months (4x/year). If the plan only covers 2, the other 2 are patient responsibility. Verify frequency before scheduling.
Some plans allow alternating D4910 and D1110. For example, D4910 twice and D1110 twice per year. Others want all four visits billed as D4910. Know the plan rules.
Updated probing depths at maintenance visits. Compare to previous charting to track stability or progression.
Prior D4341/D4342 treatment documented. Date of active treatment establishes the basis for ongoing D4910.
Document areas of pocket depth, bleeding on probing, subgingival instrumentation performed, and areas of concern.
If scheduling every 3 months, document why the shorter interval is necessary based on disease status.
Once a patient has had active periodontal therapy, they should stay on D4910 indefinitely. Periodontal disease is a chronic condition. Even if pocket depths improve and the patient is stable, the history of disease means they need periodontal-level maintenance, not routine prophylaxis. Switching back to D1110 after a year of D4910 suggests the original SRP wasn't warranted, which opens the door to an audit of the entire treatment sequence.
Alternating codes with another provider. Some patients see a periodontist for two D4910 visits and their general dentist for two D1110 visits per year. This is acceptable to most payers as long as the periodontal maintenance visits include a periodontal evaluation with updated charting. The general dentist's D1110 visits should still reference the periodontal history in the notes.
D4910 reimburses higher than D1110 in most plans. The additional reimbursement reflects the additional clinical work involved: periodontal evaluation, subgingival instrumentation in residual pockets, and assessment of treatment effectiveness. If your office bills D4910 but only performs a routine prophy without the periodontal component, the higher reimbursement isn't justified and the claim is vulnerable to audit.
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Learn about our billing servicesD4910 is the CDT code for periodontal maintenance. It is the ongoing recall cleaning for patients who have completed active periodontal treatment.
D4910 is for patients with a history of periodontal treatment. D1110 is for patients without periodontal disease. They are not interchangeable.
Coverage varies by plan. Some cover 2x/year, others 3-4x/year. Periodontal patients typically need cleanings every 3 months.
Search all 206 CDT codes in our dental coding guide.