Can you explain what the criteria for a D4341/D4342 needs to be in order to allow this code to be billed. For example, what does the pocket depths need to be? How many need to be at that level.

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  • Can you explain what the criteria for a D4341/D4342 needs to be in order to allow this code to be billed. For example, what does the pocket depths need to be? How many need to be at that level.

Can you explain what the criteria for a D4341/D4342 needs to be in order to allow this code to be billed. For example, what does the pocket depths need to be? How many need to be at that level.

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Asked on October 8, 2012
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Each carrier has there own set criteria, however, in general the following must be present.
1. pocket depths must be 4mm-5mm or higher
2. Bleeding must be present
3. Gross plaque and/or calculus present
4. Either periodontal surgery was performed or full mouth debridement prior to RPS

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Answered on October 9, 2012
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