D4346Scaling in Presence of Generalized Moderate or Severe Gingival Inflammation - Full Mouth (After Oral Evaluation)

What This Code Covers

D4346 covers scaling in presence of generalized moderate or severe gingival inflammation - full mouth (after oral evaluation). Full-mouth scaling is performed when the patient has generalized moderate to severe gingival inflammation but does not yet have a periodontal disease diagnosis. This code is distinct from D1110 (prophylaxis) and D4341/D4342 (scaling and root planing).

Billing Guide

Bill this code when:

• The evaluation described by D4346 is performed and documented by the dentist
• Clinical findings and any treatment plan changes are recorded in the chart
• The evaluation type matches the clinical scenario and patient history

Do not bill this code when:

• Another evaluation code was already billed on the same date of service
• The evaluation was performed by a hygienist without dentist involvement
• A different type of evaluation better describes the visit performed
• The procedure is better described by D4341 (Periodontal scaling and root planing - four or mor...)

Insurance and Denial Prevention

Key Payer Rules:

• Periodontal treatment is typically covered as a major service (50-80%)
• Full-mouth debridement (D4355) and D4346 may have specific frequency limits
• Surgical periodontal procedures often require documentation of previous non-surgical treatment
• Some plans require periodontal charting with probing depths for approval

Common Denials and How to Respond:

• Insufficient documentation - Submit complete periodontal charting, radiographs, and a narrative of findings.
• Non-surgical treatment not attempted first - Document previous scaling/root planing and explain why surgery is now indicated.
• Frequency exceeded - Verify the payer's frequency schedule for the specific procedure.