Navigating dental procedure codes can be challenging, especially when distinguishing between similar treatments. Two commonly confused codes in periodontal and preventive care are D4910 (Periodontal Maintenance) and D1110 (Prophylaxis - Adult). Understanding the differences between these codes is crucial for proper billing, treatment planning, and insurance coverage.

What is CDT Code D1110?

CDT code D1110 refers to a standard Adult Prophylaxis, often called a “routine” dental cleaning. This procedure is intended for patients with healthy gums and no history of periodontal disease. It involves:

• Removal of plaque, tartar, and stains from the tooth surfaces
• Polishing of the teeth
• Typically performed twice a year as part of preventive care

Insurance plans generally cover D1110 under preventive benefits, making it an essential part of routine dental visits for maintaining a healthy mouth.

What is CDT Code D4910?

CDT code D4910 is designated for “Periodontal Maintenance.” This procedure is necessary for patients who have been treated for periodontal disease and require ongoing care to prevent recurrence. D4910 includes:

• Removal of plaque, tartar, and bacterial deposits above and below the gumline
• Periodontal evaluation to monitor pocket depths and gum health
• Potential localized scaling and root planing, if needed
• Typically performed every three to four months, as determined by the patient’s periodontal condition

D4910 is only applicable after active periodontal therapy, such as scaling and root planing (D4341 or D4342), and is considered a maintenance procedure rather than a preventive service.

Key Differences Between D1110 and D4910

Why the Distinction Matters

Correctly distinguishing between these two codes is essential for accurate treatment planning and billing. Using D1110 for a patient requiring periodontal maintenance can lead to claim denials and improper care. Similarly, billing D4910 for a patient without a history of periodontal disease could result in unnecessary out-of-pocket costs.

Understanding and applying these CDT codes correctly helps ensure patients receive appropriate care while maximizing insurance benefits. If you're unsure which code applies to your treatment plan, consult with your dental provider to clarify the best course of action for your oral health.