Understanding Dental Code D4341

When to Use D4341 dental code

The D4341 dental code refers to periodontal scaling and root planing (SRP) for four or more teeth per quadrant. This CDT code is used when a patient presents with moderate to severe periodontal disease, and non-surgical intervention is necessary to remove subgingival plaque and calculus. D4341 should be reported only when there is clinical evidence of periodontal disease, such as pocket depths greater than 4mm, bleeding on probing, and radiographic evidence of bone loss. It is not appropriate for routine prophylaxis or for treating less than four teeth in a quadrant (see D4342 for fewer teeth).

Documentation and Clinical Scenarios

Accurate documentation is crucial for successful reimbursement of D4341. Dental teams should ensure that the patient's chart includes:

• Comprehensive periodontal charting (pocket depths, bleeding points, recession)
• Radiographs showing bone loss
• Detailed clinical notes describing inflammation, calculus, and patient symptoms
• Diagnosis of periodontal disease (e.g., chronic periodontitis)

Common clinical scenarios include patients with generalized periodontitis who have not responded to routine cleanings, or those with significant tartar buildup below the gumline. Always document the number of teeth treated per quadrant to justify the use of D4341 versus other scaling codes.

Insurance Billing Tips

To maximize claim acceptance for D4341, follow these best practices:

• Verify insurance coverage before treatment, as some plans have frequency limitations or require prior authorization for SRP.
• Submit complete documentation with the claim, including periodontal charting, radiographs, and clinical notes.
• Use precise narratives that explain the necessity of SRP and reference specific findings (e.g., “6mm pockets with bleeding on probing on teeth #2, 3, 4, and 5 in upper right quadrant”).
• If a claim is denied, review the EOB (Explanation of Benefits) for denial reasons and file a claim appeal with additional supporting documentation if warranted.
• Track outstanding claims in your AR (Accounts Receivable) and follow up regularly to resolve delays.

Consistent, thorough documentation and proactive communication with payers can significantly improve reimbursement rates for D4341 claims.

Example Case for D4341

Case Study: A 52-year-old patient presents with bleeding gums and discomfort. Periodontal charting reveals 5-7mm pockets in the lower left quadrant, with radiographs confirming horizontal bone loss. Four teeth (#18, 19, 20, 21) are affected. The provider diagnoses generalized moderate periodontitis and recommends SRP for the entire quadrant. The claim is submitted with D4341, including all supporting documentation. Insurance approves the claim after reviewing the detailed records, and payment is received promptly.

This example highlights the importance of matching clinical findings to the code requirements and submitting thorough documentation to support medical necessity.