Is D4210 covered by insurance?

Coverage for D4210 varies by insurance plan. It is often covered when deemed medically necessary, but pre-authorization may be required.

Can D4210 be performed on all quadrants in one visit?

While it can be performed on multiple quadrants, it depends on the patient's condition and tolerance. Insurance may have limitations on the number of quadrants treated per visit.

What postoperative care is required after a gingivectomy?

Postoperative care includes maintaining oral hygiene with gentle brushing, avoiding certain foods, and possibly using prescribed mouth rinses to aid healing.

How long is the recovery period after this procedure?

Recovery typically takes one to two weeks, during which patients may experience some discomfort and swelling, manageable with prescribed medications.

D4210

Gingivectomy/Gingivoplasty - CDT Code Guide

Periodontics/Surgical Services (Including Usual Postoperative Care)

Overview

CDT code D4210 pertains to the procedure of gingivectomy or gingivoplasty involving four or more contiguous teeth or tooth-bounded spaces per quadrant. This surgical procedure is typically performed to eliminate suprabony pockets, which are pockets above the bone, or to restore normal gingival architecture. This is particularly necessary when there are gingival enlargements or asymmetrical or unaesthetic topographies, despite a normal bony configuration. The procedure involves the removal of excess gum tissue to improve oral health and aesthetics, often enhancing the patient's ability to maintain oral hygiene. Dental professionals may recommend this procedure in cases of chronic periodontal disease where non-surgical treatments have not been successful.

When to Use This Code

When there are suprabony pockets that do not respond to non-surgical periodontal therapy.
In cases of gingival enlargement due to medication or systemic conditions.
To correct asymmetrical gingival contours that affect aesthetics.
When normal gingival architecture needs to be restored for better oral hygiene access.
In preparation for restorative or cosmetic dental procedures requiring optimal gingival health.

Documentation Requirements

Detailed periodontal charting showing pocket depths.
Clinical notes describing the gingival condition and rationale for surgery.
Pre-operative and post-operative photographs, if applicable.
Patient consent forms acknowledging understanding of the procedure.
Documentation of previous non-surgical periodontal therapies attempted.

Billing Considerations

When billing for D4210, ensure that the procedure is justified by clinical findings such as pocket depths and gingival enlargement. Frequency limitations may apply, and it is important to check with the patient's insurance for coverage specifics. Common modifiers, such as those indicating multiple quadrants treated, may be necessary. Coordination with insurance providers can help determine if pre-authorization is required.

Related CDT Codes

D4211 D4260 D4261 D4341 D4342

Frequently Asked Questions

Gingivectomy involves the removal of gum tissue to eliminate pockets, while gingivoplasty reshapes the gums to improve aesthetics and function.

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