What do I code for the 4-6 week tissue re-eval after SRP?

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What do I code for the 4-6 week tissue re-eval after SRP?

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I completed 4 quads of SRP and 4 weeks later the patient came back in for the re-eval appointment. Do I use D4910 or D0171. I spot probed, scaled residual calculus, polished, flossed, and applied fluoride varnish. Also I placed Arestin on two pockets.

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Asked on January 5, 2022
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Since the patient had 4 quads of SRP, the patient is a PM at that point. Just as an FYI, the first PM appointment is usually 90 days post SRP. So, for example, Delta is denying our D4910's within 90 days of SRP. This is a WRITE OFF. Not billable.

Since it was NOT past the 90-day mark, I would bill this as D0171. After the 90 days you may want to consider D4910. Like most codes, the payor may or may not cover it. It's going to depend on the policy because it's likely that D0171 will not be paid.

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Answered on May 18, 2022
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