How often can D4381 be performed on a patient?

The frequency of D4381 usage can depend on the patient's specific periodontal condition and insurance policy limitations. Typically, it is used as needed based on clinical findings.

Can D4381 be used in conjunction with other periodontal treatments?

Yes, D4381 is often used alongside scaling and root planing to enhance treatment outcomes and manage localized infections more effectively.

What are the benefits of using localized antimicrobial delivery?

Localized antimicrobial delivery targets specific periodontal pockets, reducing systemic exposure to antibiotics and providing higher concentrations of medication directly at the site of infection.

What types of antimicrobial agents are used in D4381?

FDA-approved antimicrobial agents such as chlorhexidine or doxycycline are commonly used in subgingival delivery devices for this procedure.

D4381

Localized Antimicrobial Delivery - CDT Code Guide

Periodontics/Non-Surgical Periodontal Service

Overview

CDT Code D4381 refers to the localized delivery of antimicrobial agents via a controlled release vehicle into diseased crevicular tissue, applied per tooth. This procedure involves the insertion of FDA-approved subgingival delivery devices into periodontal pockets. These devices release antimicrobial medications slowly, maintaining a therapeutic concentration at the site of action to effectively suppress pathogenic bacteria. This non-surgical periodontal service is typically used in cases where patients exhibit localized periodontal infections that require targeted antimicrobial intervention. It is a crucial component of periodontal therapy aimed at managing and treating periodontal disease without surgical intervention.

When to Use This Code

When a patient has localized periodontal pockets with persistent infection despite standard cleaning procedures.
In cases where systemic antibiotics are not suitable or effective for the patient.
For patients with a history of periodontal disease who show signs of localized infection during maintenance visits.
When a patient is contraindicated for surgical periodontal therapy but requires localized treatment.
In conjunction with scaling and root planing procedures to enhance treatment outcomes.

Documentation Requirements

Detailed periodontal charting indicating the presence of periodontal pockets.
Clinical notes describing the diagnosis and rationale for using localized antimicrobial therapy.
Documentation of the specific antimicrobial agent used and the tooth or teeth treated.
Patient consent forms acknowledging understanding of the procedure and its purpose.
Progress notes documenting the patient's response to treatment and any follow-up care.

Billing Considerations

D4381 is typically billed per tooth and may have frequency limitations based on insurance policies. It is important to verify with the patient's insurance provider regarding coverage and any pre-authorization requirements. Common modifiers may include those indicating the specific tooth treated. Ensure accurate documentation to support the necessity of the procedure.

Related CDT Codes

D4341 D4342 D4910 D1206

Frequently Asked Questions

Coverage for D4381 varies by insurance provider. It's essential to check with the patient's insurance for specific coverage details and any pre-authorization requirements.

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