INSURANCE CONNECTION continued
Dominion Dental : We expect no more than two quadrants are treated on one date of service . D4341 is typically approved only if four or more teeth in the quadrants are involved . Upon clinical review , claims with fewer than four teeth with pocket depths of 5 mm and greater are approved as D4342 , as pert the CDT descriptor . There is no limit on the number of D4342 procedures that may be filled on the same date of service .
UCCI : If more than two quadrants of S / RP are provided for the same patient on the same date of service , a narrative must also be included detailing why the treatment was provided on the same date of service .
PDA Question : Is there a certain time period that must precede or follow a dental prophylaxis in order for the benefit of scaling and root planing to be approved ?
Cigna : A dental prophylaxis and scaling and root planing are not allowed on the same date of service .
Delta Dental : A dental prophylaxis can be performed any time prior to periodontal scaling and root planing . However , a prophylaxis is not benefited on the same date of service as scaling and root planing , and there is a waiting period of 30 days after the last quadrant of root planing before a dental prophylaxis of periodontal maintenance will be benefited .
Dominion Dental : We do not have any requirements related to prophylaxis preceding or following S / RP .
UCCI : Generally , a 45-day time period must occur between a prophylaxis and S / RP .
* Cigna disclaimer : Please note that Cigna Dental administers dental plans for a large number of clients , and many of these clients have specific plan guidelines which Cigna is required to follow . Therefore , while the responses below reflect the general guidelines for Cigna Dental , the dental plan guidelines for a specific patient may be different from those described below .
( PDA notes that this can be that the above disclaimer applies to all dental insurers ).
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