How often can D4921 be billed?

The frequency of billing for D4921 depends on the patient's periodontal condition and insurance policy. Some plans may limit the number of times it can be billed annually.

What medicinal agents are commonly used with D4921?

Common agents include chlorhexidine, povidone-iodine, and other antimicrobial solutions tailored to the patient's specific needs.

Is D4921 performed during regular cleanings?

D4921 is not typically part of a regular cleaning but is used during periodontal maintenance or treatment visits for patients with specific periodontal needs.

D4921

Gingival Irrigation - CDT Code Guide

Q: Can D4921 be used for all patients?

D4921 is typically used for patients with periodontal disease or those undergoing periodontal therapy. It may not be necessary for patients with healthy gums.

Periodontics/Other Periodontal Services

Overview

CDT code D4921 refers to the procedure of gingival irrigation with a medicinal agent per quadrant. This periodontal service involves the application of a therapeutic solution to the gingival sulcus or periodontal pocket to reduce bacterial load and inflammation. Typically performed as part of a periodontal maintenance program, this procedure is essential for patients with periodontal disease or those undergoing periodontal therapy. Gingival irrigation can help in managing gingivitis and periodontitis by delivering antimicrobial agents directly to the affected areas, promoting healing and reducing the risk of further periodontal deterioration.

When to Use This Code

During periodontal maintenance visits for patients with a history of periodontal disease.
When treating patients with gingivitis to reduce inflammation and bacterial load.
As part of a comprehensive periodontal therapy plan following scaling and root planing.
For patients with periodontal pockets that require localized antimicrobial treatment.
In cases where systemic antibiotics are contraindicated or insufficient.

Documentation Requirements

Detailed record of the specific medicinal agent used during the procedure.
Documentation of the patient's periodontal condition and diagnosis.
Clinical notes on the specific quadrants treated during the visit.
Evidence of informed consent from the patient for the procedure.
Progress notes indicating the patient's response to previous periodontal treatments.

Billing Considerations

When billing for D4921, it's important to note that this code is typically used in conjunction with other periodontal procedures such as scaling and root planing. Ensure that the treatment is documented as medically necessary. Be aware of any frequency limitations imposed by insurance carriers, as some may restrict the number of times gingival irrigation can be billed within a certain period. Common modifiers include those indicating the specific quadrant treated. Always verify with the patient's insurance provider for coverage details.

Related CDT Codes

D4341 D4342 D4910 D0180 D0150

Frequently Asked Questions

Coverage for D4921 varies by insurance plan. It's important to check with the patient's provider to determine if gingival irrigation is covered and any associated limitations.

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