One of eleven new CDT codes coming to life in January, 2017 is D4346 scaling in presence of generalized moderate or severe gingival inflammation – full mouth, after oral evaluation. This code will be included in the SoftDent Annual CDT Code Update, which will be shipping to our clients later in 2016. So why am I writing about this one new code from the group of eleven? Well, this particular code appears to be very confusing in its usage. In fact, D4346 promises to be so challenging to dentists that the ADA has written a 10 page guide to using it! Seems like this new code should be handled with care. I will attach a link to the ADA guide at the end of this post for your reference.
It will be interesting to see how insurance carriers will handle D4346. Will it be covered? It's too early to tell, but some quick research indicates that carriers will be all over the board on this. Some will reimburse it as a standard prophy (D1110), others may cover it based on a relative value of 1.5 - 2x a prophy, still others will exclude it completely. Lots more to come as we close in on 2017.
D4346 will be available for use on January 1, 2017.
A Guide to Reporting D4346