Dental code D4910 refers to periodontal maintenance, a critical procedure for patients who have been treated for periodontal disease. Proper use of this code ensures that both the dental practice and the patient receive appropriate benefits from insurance providers while maintaining compliance with industry standards.

What is D4910?

D4910 is used for periodontal maintenance therapy following active periodontal treatment, such as scaling and root planing (SRP) or periodontal surgery. It is not a prophylactic cleaning (D1110) but is instead designed for patients who have a history of periodontal disease and require ongoing care to prevent recurrence.

When Should D4910 Be Used?

A dental office should use D4910 in the following situations:

• After a patient has completed active periodontal therapy (such as SRP or surgery).

• When the patient has been diagnosed with periodontal disease and requires ongoing supportive therapy.

• Typically every 3 to 4 months, as recommended by periodontal specialists.

• When documentation shows the need for continuous periodontal monitoring, including probing depths, inflammation, or bleeding on probing.

When NOT to Use D4910

• For patients with no history of periodontal disease – Instead, D1110 (prophylaxis) should be used.

• Immediately after a standard cleaning – If a patient has healthy gums and does not require ongoing periodontal care, this code is not appropriate.

• For an initial deep cleaning (SRP) – The proper codes for active periodontal therapy are D4341 (scaling and root planing per quadrant) and D4342 (scaling and root planing per one to three teeth).

Billing and Insurance Considerations

• Most insurance providers require prior periodontal treatment before approving D4910.

• D4910 is generally covered at a lower frequency than prophylaxis (D1110)—often every 3-4 months instead of twice a year.

• Patients should be informed about potential out-of-pocket costs if their insurance plan limits coverage.

• Proper documentation is essential—including periodontal charting, clinical notes, and radiographic evidence of bone loss.

• Alternating between D4910 and D1110 is generally not recommended, as insurance companies may deny claims if the patient has a history of periodontal disease.

Best Practices for Documentation

To ensure successful reimbursement and avoid claim denials, make sure to:

• Record updated periodontal charting at each visit.

• Document bleeding points, pocket depths, and any clinical findings that justify periodontal maintenance.

• Keep a record of previous periodontal treatments to prove eligibility.

• Use clear and concise language in the patient’s chart to explain why continued periodontal maintenance is needed.

Conclusion

Understanding and properly using D4910 ensures that periodontal patients receive necessary maintenance care while allowing dental offices to be appropriately reimbursed. By following the correct guidelines, documenting thoroughly, and educating patients about their ongoing periodontal needs, dental professionals can help maintain oral health and avoid insurance complications.