Cracking Periodontal Codes...
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www.katrinasanders.com [email protected] Cracking Periodontal Codes with Class: Diagnostic Decisions Speaker: Katrina M. Sanders RDH, BSDH, M.Ed, RF Caton J, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions – Introduction and key changes from the 1999 classification. J Periodontol. 2018; 89 (Suppl 1): S1-S8. Periodontal Health, Gingival Diseases & Conditions Periodontitis Periodontal Health & Gingival Health Gingivitis: Dental Biofilm- Induced Gingival Diseases: Non-Dental Biofilm- induced Necrotizing Periodontal Diseases Periodontitis Periodontitis as a manifestation of Systemic Disease Other Conditions Affecting the Periodontium Systemic diseases or conditions affecting the periodontal supporting tissues Periodontal abscesses and endodontic- periodontal lesions Mucogingival deformities and conditions Traumatic occlusal forces Tooth and prosthesis related factors Peri-Implant Diseases and Conditions Peri-implant Health Peri-implant Mucositis Peri-implantitis Peri-implant Soft and Hard Tissue Deficiencies Stage Stage I Stage II Stage III Stage IV Severity Interdental CAL 1-2mm 3-4mm 5mm or less 5mm or more RBL Coronal third (<15%) Coronal third (15%-33%) Extending to mid- third of root and beyond Extending to mid-third of root and beyond Tooth loss No tooth loss due to periodontitis Tooth loss due to periodontitis Tooth loss due to periodontitis Complexity Local Max probing depth 4mm Mostly horizontal bone loss Maxi probing depth 5mm Mostly horizontal bone loss In addition to Stage II: Probing depth 6mm Vertical bone loss Furcation involvement cls II or III Moderate ridge defect In addition to stage III: Need for complex rehabilitation due to: Masticatory dysfunction Secondary occlusal trauma Severe ridge defect Bite collapse, drifting, flaring Less than 20 remaining teeth Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018; 89 (Suppl 1): S159-S172.
Transcript of Cracking Periodontal Codes...
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Cracking Periodontal Codes with Class: Diagnostic Decisions Speaker: Katrina M. Sanders RDH, BSDH, M.Ed, RF
Caton J, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions – Introduction and key changes from the 1999 classification. J Periodontol. 2018; 89 (Suppl 1): S1-S8.
Periodontal Health, Gingival Diseases & Conditions
Periodontitis
Periodontal Health & Gingival Health
Gingivitis: Dental Biofilm-Induced
Gingival Diseases:
Non-Dental Biofilm-induced
Necrotizing Periodontal
Diseases
Periodontitis Periodontitis as a
manifestation of Systemic
Disease
Other Conditions Affecting the Periodontium
Systemic diseases or conditions
affecting the periodontal supporting
tissues
Periodontal abscesses and
endodontic-periodontal
lesions
Mucogingival deformities and
conditions
Traumatic occlusal forces
Tooth and prosthesis
related factors
Peri-Implant Diseases and ConditionsPeri-implant Health Peri-implant Mucositis Peri-implantitis Peri-implant Soft and
Hard Tissue Deficiencies
Stage Stage I Stage II Stage III Stage IV
Severity Interdental CAL
1-2mm 3-4mm 5mm or less 5mm or more
RBL Coronal third (<15%)
Coronal third (15%-33%)
Extending to mid-third of root and beyond
Extending to mid-third of root and beyond
Tooth loss No tooth loss due to periodontitis
Tooth loss due to periodontitis
Tooth loss due to periodontitis
Complexity Local Max probing depth 4mm
Mostly horizontal bone loss
Maxi probing depth 5mm
Mostly horizontal bone loss
In addition to Stage II:
Probing depth 6mm
Vertical bone loss
Furcation involvement cls II or III
Moderate ridge defect
In addition to stage III:
Need for complex rehabilitation due to:
Masticatory dysfunction
Secondary occlusal trauma
Severe ridge defect
Bite collapse, drifting, flaring
Less than 20 remaining teeth
Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018; 89 (Suppl 1): S159-S172.
www.katrinasanders.com [email protected]
This slide contains content from the "ADA Guide to Reporting D4346" that is protected by copyright (©2018 American Dental Association (ADA). All rights reserved)
Licensed to use ADA CDT codes granted to Katrina Sanders, enabling the speaker and host association to present CDT Codes. The Code on Dental Procedures and Nomenclature is published in CDT 2018 Current Dental Terminology, Copyright 2018, American Dental Association (ADA) All rights reserved.
www.katrinasanders.com [email protected]
New Trends in Coding HbA1c in-office point of service testing
n This code is to be used when drawing a blood sample and performing point of service analysis of the sample by a dentist
n D0411 n Submitted by Delta Dental Plans
Teledentistry – synchronous; real-time encounter
n D9995 n Separate procedure documented and reported in addition to other procedures (e.g., diagnostic)
delivered to the patient on the date of service. n Submitted by American Dental Association: Council on Dental Benefit Programs
Teledentistry – asynchronous; delayed encounter
n D9996 n Separate procedure documented and reported in addition to other procedures (e.g., diagnostic)
delivered to the patient on the date of service. n Submitted by American Dental Association: Council on Dental Benefit Programs
Interim caries arresting medicament application – per tooth
Licensed to use ADA CDT codes granted to Katrina Sanders, enabling the speaker and host association to present CDT Codes. The Code on Dental Procedures and Nomenclature is published in CDT 2018 Current Dental Terminology, Copyright 2018, American Dental Association (ADA) All rights reserved.
Peri-Implant Health
Peri-Implant Mucositis
Peri-Implantitis Peri-Implant Soft and Hard Tissue Deficiencies
Mucosa is keratinized or non-keratinized
Inflammatory lesion of the soft tissue surrounds implant
Bleeding on probing & visual signs of inflammation.
Reversible with plaque elimination
Pathological condition characterized by plaque-induced inflammation of the peri-implant connective tissue and subsequent progressive loss of supporting bone
Contributed by etiological factors: systemic disease, medications, tissue turnover, trauma, local disease, biochemical factors, tissue morphology
Intrabony aspect is in contact with mineralized bone
Absence of supporting bone or continuing marginal bone loss
Progressive loss of supporting bone
Loss of support from mechanical or idiopathic means
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n Verbiage: conservative treatment of an active, non-symptomatic carious lesion by topical application of a caries arresting or inhibiting medicament and without mechanical removal of sound tooth structure
n Revise D1354 code n The Code Maintenance Committee determined that the submissions’ proposed wording change
clarifies the procedure’s intended nature and scope. n Submitted by American Academy of Pediatric Dentistry
2019 CDT Codes D0421
n blood glucose level test – in-office using a glucose meter n This procedure provides an immediate finding of a patient’s blood glucose level at the time of sample
collection for the point-of-service analysis. D9613
n infiltration of sustained release therapeutic drug – single or multiple sites n Infiltration of a sustained release pharmacologic agent for long acting surgical site pain control. Not for
local anesthesia purposes. Occlusal Guards
n D9944 | occlusal guard – hard appliance, full arch n Removable dental appliance designed to minimize the effects of bruxism or other occlusal
factors. Not to be reported for any type of sleep apnea, snoring or TMD appliances. n D9945 | occlusal guard – soft appliance, full arch
n Removable dental appliance designed to minimize the effects of bruxism or other occlusal factors. Not to be reported for any type of sleep apnea, snoring or TMD appliances.
n D9946 | occlusal guard – hard appliance, partial arch n Removable dental appliance designed to minimize the effects of bruxism or other occlusal
factors. Provides only partial occlusal coverage such as anterior deprogrammer. Not to be reported for any type of sleep apnea, snoring or TMD appliances.
Additional Codes:
n D5876 | add metal substructure to acrylic full denture (per arch) n D9990 | certified translation or sign-language services – per visit n D9961 | duplicate/copy patient's records
Licensed to use ADA CDT codes granted to Katrina Sanders, enabling the speaker and host association to present CDT Codes. The Code on Dental Procedures and Nomenclature is published in CDT 2018 Current Dental Terminology, Copyright 2018, American Dental Association (ADA) All rights reserved.
www.katrinasanders.com [email protected]
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