The D4355 (FMD) intent is to remove gross debridement scheduled on later visits. The debridement dental code equips dentists to clean supragingival or subgingival plaque for patients. This helps with a thorough periodontal evaluation and enables diagnosis down the line. Removing debris reduces inflammation, promotes quick recovery, and supports accurate periodontal charting and probing.
Periodontal charting and probing help in diagnosis. Dental code debridement D4355 promotes periodontal therapy followed by definitive treatment.
In 2018, the CMC (Code Maintenance Committee) of the ADA provided updated CDT data to classify admitted patient care on subsequent visits.
What is the intended use of this nomenclature? This post provides clarity on the D4355, as referred to in other CDT codes.
How to code D4355 for the reimbursement?
FMD (full mouth debridement) is performed independently and cannot be used interchangeably in the insurance context. The services are limited to oral assessment, professional dental cleaning, patient guidance, dental X-rays, relief of pain due to terminal diseases, diagnostic imaging, and dental problems outside clinical hours, such as emergency or urgent care.
The time restriction to attain these services is within 36 months. FMD has insurance restrictions and is not covered within 36 months of other services, like diagnostic, preventive, and periodontal services. FMD is not performed on the same day as D0160 because of problem-focused coding, and D0180 due to detailed examination of tooth structure and gums.
These restrictions are encountered in dental insurance policies that require the appointment of FMD and a comprehensive evaluation on separate days for reimbursement.
To proceed with billing services, D0191 helps determine whether the patient requires further treatment through an assessment. It identifies the patient's immediate needs and signs of malformation, disease, and injury by following the guidelines. The dentists can evaluate if the patient requires further diagnostic tests and treatment. This step establishes a link between emergency care and detailed examination.
D1330 includes everything related to home care, including the dental care instructions for patients to avoid a mess. A visual demonstration of brushing and flossing.
D9630 includes medications for patients to use at home, dosage, and quantity, such as pain relievers, antibiotics, and fluorides.
Dental code debridement D4355 & D0140
D0140 is a limited oral evaluation. The goal is to relieve pain and control gingival bleeding through the buildups. Therefore, the debridement procedure cannot be performed along with other specific evaluations. The dental provider conducts D0140 on a separate day, which allows the tissues to heal. D4355 needs a subsequent visit.
FMD is the first step towards D0180, or D0120 as a follow-up visit.
Debridement dental code D4355 & D0150, D0120
The recent update in CDT codes 2023 removes the confusion; the ADA allows a couple of evaluations on the same day as the necessary treatment. D0150 (comprehensive procedure) or D0120 (periodic oral evaluation procedure) can be performed in one day with D4355.
D0180 takes more than one day and cannot be clubbed with FMD. In fact, it is for a periodontal assessment for a returning patient or a walk-in.
The patient undergoes a full-mouth debridement, scheduling D0180 for the next appointment while helping patients recover from the procedure. The patient stopped further treatment. The dental billing process remains D4355 to demonstrate the contract. The practitioner would deliver and bill services under compliance.
The Dental Code For Debridement: Same as Cleaning
FMD focuses on removing plaque and calculus that can lead to other periodontal diseases. It can be easily sensed by pain and bleeding gums, making the patient uncomfortable. While deep cleaning protects tissues, roots, and checks every tooth for gum disease.
FMD is a professional cleaning that removes gross debris from surfaces that are otherwise difficult to reach through flossing and brushing during a diagnostic exam. On the contrary, deep cleaning involves professionals taking care of the gumline from periodontal pockets to treat infections. It helps in regenerative procedures, thereby reducing inflammation and focusing on patients.
FMD is the beginning of other dental procedures. SRP stabilizes their periodontal condition and structure.
Is FMD a necessary procedure?
The patients require FMD for specific dental treatments. Here is why FMD is necessary in some cases:
Gum Health Maintenance
Good gum health means no bacterial film accumulation on the teeth. The debris triggers gum inflammation, called gingivitis. The consequences can result in periodontal disease. FMD removes debris deposits to avoid complications.
Follow-up Treatments
Dental prosthetics are stable on a clean mouth. Debris accumulation can hinder the diagnosis. FMD acts as a solution for restorative treatments, cleaning, or targeting a specific issue.
Elevating Oral Care
Patients develop a habit of oral hygiene. The debridement procedure maintains hygiene through cleaning that would otherwise be missed.
Aesthetic Advantages
Cleaner and brighter teeth improve the smile. It removes all the foreign material, thereby smoothing the roots and maintaining clean teeth.
What to Expect in a Non-Surgical FMD Procedure?
Dental procedures can create an uncomfortable experience for patients. Although FMD is not painful if performed by specialists. Through x-rays and periodontal measurements, the dentists examine the buildups and start with the cleaning process.
During the procedure, the patient is provided with anesthesia to numb the treated area and minimize the pain effects through specialized instruments. All the plaque and tartar are removed. Sequencing with teeth polishing to prevent future decay.
The aim is to provide maximum comfort without worrying about the convoluted aspect of the procedure.
The dental practice is busy with patients. Who will handle the claim processing? Staying ahead with CDT coding is a challenge. Happy patients result in better financial outcomes, and look no fur
