Periodontal Disease- Classifications and Coding

Our office recently decided to review the ADA and AAP classifications of periodontal disease. Its amazing how you forget things if you don't use them all the time :)

(based primarily on attachment loss)

Case Type I: Gingivitis: no attachment loss, bleeding may or may not be present

Case Type II: Early Periodontitis: pocket depths or attachment loss 3 - 4 mm
                                                   BOP may be present
                                                   localized areas of recession
                                                   possible class I furcation involvement

Case Type III: Moderate Periodontitis: pocket depths or attachment loss 4 - 6mm
                                                           BOP
                                                         Grade I or II furcation
                                                         class I mobility

Case Type IV: Advanced Periodontitis:  pocket depths or attachment loss over 6mm
                                                             BOP
                                                             Grade II or III furcation
                                                             mobility Class II or III




(identifies distinct types of periodontal disease by subdivision)
for a more comprehensive list click here

Gingivitis
  • Plaque- Associated Gingivitis
    • Chronic Gingivitis
    • ANUG (acute necrotizing ulcerative gingivitis)
    • Gingivitis associated with systemic conditions or Medications
      • Hormone induced
      • Drug induced
      • Linear Gingival Erythema
  • Gingival Manifestations of Systemic Diseases and Mucocutanieous Lesions
    • Bacterial, Viral or Fungal
    • Blood Dyscrasias
    • Mucocutaneous Diseases (lichen planus, cicatricial pemphigoid)
Periodontitis

  • Adult Periodontitis- plaque associated
  • Early - Onset Periodontitis
    • Prepubertal
    • Juvenile Periodontitis
    • Rapidly Progressive Periodontitis
  • Periodontitis Associated with Systemic Diseases
  • Necrotizing Ulcerative Periodontitis
  • Refractory
  • Peri-implantitis

ADA CDT Codes

D1110 : Adult Prophy; removal of plaque, calculus and stain from the tooth structures in the permanent and transitional dentition. It is intended to control local irritational factors.

D4910: Periodontal Maintenance; this procedure is instituted following SCRP and continues in varying intervals... if new or recurring periodontal disease appears additional diagnostic and treatment procedures must be considered (maintain disease remission)

D4341: SCRP four or more teeth per quadrant; crown and root

D4342: SCRP one to three teeth per quadrant

D0180: Comprehensive Periodontal evaluation- new or established patients showing signs or symptoms of disease


For more information on coding and billing click here

Comments

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  4. When gingivitis is not treated, it can advance to “periodontitis” (which means “inflammation around the tooth”). In periodontitis, gums pull away from the teeth and form spaces (called “pockets”) that become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s natural response to infection start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed. You can also find more references and review on the dental services.

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