Phase 1 Periodontal Therapy
Commonly Used "ADA" Codes

D0180	Comprehensive periodontal evaluation New or established patient.  This procedure is indicated for patients showing signs or symptoms of periodontal disease and for patients with risk factors such as smoking or diabetes.  It includes evaluation of periodontal conditions, probing and charting, evaluation and recording of the patient's dental and medical history and general health assessment.  It may include the evaluation and recording of dental caries, missing or unerupted teeth, restorations, occlusal relationships and oral cancer screening.
D1110	Prophylaxis - adult A dental prophylaxis performed on transitional or permanent dentition that includes scaling and/or polishing procedures to remove coronal plaque, calculus and stains.
D1330	Oral Hygiene Instructions This may include instructions for home care. Examples includetooth brushing technique, flossing, use of special oral hygiene aids.
D1204	Topical Application of flouride (prophylaxis not included) -adult This code is used when reporting prophylaxis and flouride procedures separately

INSTRUMENTATION PROCEDURES

D4341	Periodontal scaling and root planing - four or more contiguous teeth or bounded teeth spaces per quadrant The procedure involves instrumentation of the crown and root surfaces of the teeth to remove plaque and calculus from these surfaces.  It is indicated for patients with periodontal disease and is therapeutic, not prophylactic, in nature.  Root planing is the definitive procedure designed for the removal of cementum and dentin that is rough, and/or permeated by calculus or contaminated with toxins or microorganisms.  Some soft tissue removal occurs.  This procedure may be used as a definitive treatment in some stages of periodontal disease and/or as a part of pre-surgical procedures in others.
D4342	Periodontal scaling and root planing - one to three teeth, per quadrant This procedure involves instrumentation of the crown and root surfaces of the teeth to remove plaque and calculus from these surfaces.  It is indicated for patients with periodontal disease and is therapeutic, not prophylactic, in nature.  Root planing is the definitive procedure designed for the removal of cementum and dentin that is rough, and/or permeated by calculus or contaminated with toxins or microorganisms.  Some soft tissue removal occurs.  This procedure may be used as a definitive treatment in some stages of periodontal disease and/or as a part of pre-surgical procedures in others. (same descriptor as D4341)
D4355	Full mouth debridement to enable comprehensive periodontal evaluation and diagnosis. The removal of subgingival and / or supragingival plaque and calculus. This is a preliminary procedure and does not preclude the need for other procedures. This procedure may be necessary more than once and may require multiple visits to complete

EXODONTIA PROCEDURES

D7140

EXTRACTIONS (INCLUDES LOCAL ANESTHESIA, SUTURING, IF NEEDED AND ROUTINE POSTOPERATIVE CARE Extraction, erupted tooth or exposed root (elevation and/or forceps removal)

MISCELLANEOUS PROCEDURES

D9910	Application of desensitizing Medicament Includes in-office treatment for root sensitivity. Typically reported on a "per visit" basis for application of topical flouride. This code is not to be used for bases, liners, or adhesives used under restorations.
D9951	Occlusal adjustment- limited May also be known as equilbration; reshaping the occlusal surfaces of teeth to create harmonious contact relationships between the maxillary and mandibular teeth. Presently includes discing/odontoplasty/enamoplasty. Typically reported on a "per visit" basis.
D9971	Odontoplasty 1-2 teeth; includes removal of enamel projections

OCCLUSAL GUARD

D9940

Occlusal guard, by report. Removable dental appliances which are designed to minimize the effects of bruxism (grinding) and other occlusal factors. Note – this does not include “athletic mouth guards” D9941 – fabrication of athletic mouth guards.