Treatment codes on a periodontal plan Patient guide

The codes on a periodontal treatment plan are CDT codes, the HIPAA standard code set for dental records and claims, published by the American Dental Association. D4341 is scaling and root planing for four or more teeth in a quadrant. D4910 is periodontal maintenance, the cleaning code after periodontal treatment.

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What do exam and x-ray codes mean?

Exam and x-ray codes cover the evaluation and images that come before treatment, and D0180 is the comprehensive periodontal evaluation.

Code	What it covers
D0150	Full oral exam of a new or returning patient
D0180	Full periodontal exam of a new or returning patient
D0140	Limited exam focused on one problem
D0170	Limited recheck of one problem in an established patient, outside a post-surgery visit
D0210	Full series of x-rays taken inside the mouth
D0330	Panoramic x-ray
D0367	3D cone-beam CT of both jaws, taken and read
D9310	Consultation by a dentist other than the one who asked for it

Aetna's re-evaluation policy lists D0170, D0180 and D0140 as the codes for re-checking the gums after scaling and root planing, with pocket readings recorded and compared to the first chart. Ask whether the plan covers a CBCT scan before it is taken. The first visit.

What do deep cleaning and maintenance codes mean?

Deep cleaning codes are billed by quadrant, and maintenance has its own code. The ADA divides the dental arches into four equal sections called quadrants, each running from the midline back to the last tooth.

Code	What it covers
D4341	Scaling and root planing, four or more teeth in a quadrant
D4342	Scaling and root planing, one to three teeth in a quadrant
D4346	Full-mouth scaling for widespread moderate or severe gum inflammation, after an exam
D4355	Full-mouth debridement so the periodontal exam can be done at a later visit
D4381	Antimicrobial placed in a pocket in a slow-release form, per tooth
D4910	Periodontal maintenance
D1110	Routine adult cleaning (prophylaxis)
D4999	Unspecified periodontal procedure, described in a note

The ADA added D4346 in CDT 2017 for patients between a routine cleaning and root planing. BCBS Kansas notes that D4999 is commonly reported for bacterial decontamination, often with a diode laser. Scaling and root planing. Deep cleaning or regular cleaning.

What do gum surgery codes mean?

Gum surgery codes name the procedure and the number of teeth per quadrant, with separate codes for bone grafts and membranes.

Code	What it covers
D4210, D4211	Gingivectomy or gingivoplasty: four or more teeth, or one to three teeth, per quadrant
D4240, D4241	Gum flap with root planing, by the same tooth counts
D4249	Clinical crown lengthening involving bone (hard tissue)
D4260	Osseous surgery with a full-thickness flap, four or more teeth per quadrant
D4261	Osseous surgery, one to three teeth per quadrant
D4263	Bone graft at a natural tooth, first site in the quadrant
D4264	Each added bone graft site in the same quadrant
D4266	Guided tissue regeneration with a membrane that dissolves, per site
D4267	Guided tissue regeneration with a membrane that does not dissolve, removal included

Cleveland Clinic lists membranes and bone grafts as possible parts of osseous surgery, so graft and membrane codes can appear beside the osseous surgery line. Osseous surgery. Gum flap surgery.

What do gum graft codes mean?

Gum graft codes separate the patient's own tissue from donor material and bill the first tooth and each added tooth separately.

Code	What it covers
D4270	Pedicle soft tissue graft
D4273	Connective tissue graft from the patient's own tissue, first tooth, implant or gap; donor and recipient sites included
D4283	Each added tooth in the same graft site, own tissue
D4275	Connective tissue graft from donor material, first tooth, implant or gap
D4285	Each added tooth in the same graft site, donor material
D4277	Free soft tissue graft, first tooth, implant or gap; donor and recipient sites included
D4278	Each added tooth in the same free graft site
D4276	Connective tissue graft combined with a double pedicle graft, per tooth

The Pinhole developer states that coverage for gum recession treatment is often set by diagnosis and medical necessity. Ask whether the plan has a limit on graft sites per visit. Gum grafting. Pinhole.

What do implant and sedation codes mean?

Implant plans combine surgical, graft and crown codes, and sedation appears as its own timed line.

Code	What it covers
D7140	Extraction of an erupted tooth or exposed root
D7210	Extraction of an erupted tooth that requires bone removal
D7953	Bone graft to preserve the ridge after extraction, per site
D7951	Sinus augmentation with bone or a bone substitute
D7952	Sinus augmentation through a vertical approach
D6010	Surgical placement of an implant into the jawbone
D6104	Bone graft at the time of implant placement
D6057	Custom abutment, placement included
D6058, D6065	Porcelain or ceramic crown on an abutment, or on the implant itself
D9230	Nitrous oxide
D9239, D9243	IV moderate sedation, first 15 minutes, then each added 15 minutes
D9222, D9223	Deep sedation or general anesthesia, same timing

Dental implant process. Sedation.

Questions

Why does my estimate list D4341 more than once?

D4341 is billed per quadrant, so a full-mouth deep cleaning can appear as a separate line for each quadrant treated. The ADA divides the dental arches into four quadrants. A quadrant with only one to three teeth needing treatment is billed as D4342. Ask the office to label each line with its quadrant, such as upper right.

What is the dental code for peri-implantitis treatment?

Peri-implant codes depend on the procedure. D6081 is scaling and debridement around one inflamed implant without opening a flap. D6101 is debridement of a peri-implant defect with flap entry, and D6102 adds bone recontouring. D6103 is a bone graft to repair the defect, and D6106 or D6107 covers a membrane.

Why did my insurance pay less than the estimate?

Several plan rules lower payment. An alternate benefit clause lets the plan pay for a less expensive alternative procedure. Downcoding pays a different code than the one submitted. Bundling combines codes into a smaller benefit. The plan's annual maximum also caps payment. The explanation of benefits states what was covered and why.

What is a pre-treatment estimate?

A pre-treatment estimate, or predetermination, is the dentist's submission of the treatment plan to the dental plan before treatment begins. The plan replies with some or all of: the patient's eligibility, covered services, amounts payable, co-payments, deductibles and plan maximums. Delta Dental encourages asking for one before specialist treatment.

How often do dental codes change?

The CDT Code is reviewed every year. The ADA's Code Maintenance Committee holds an annual meeting to agree on code additions, revisions and deletions. Changes agreed at its March 2026 meeting go into the next edition of the code. The ADA posts the committee's decisions online for anyone to download for free. Ask the office to confirm the current code on an older estimate.

Is laser gum treatment coded differently?

Some laser services use the unspecified code. BCBS Kansas notes that D4999, unspecified periodontal procedure, is commonly reported for bacterial decontamination, often with a diode laser. The insurer asks offices to add a note on the claim that names the laser method. Ask the office which code it will use for any laser step, and request a pre-treatment estimate.

Sources

Reviewed by Steve Schadt, Director of IT and Medical Compliance: 25 years in dentistry, medicine and HIPAA compliance. Updated 2026-10-02. Checked against the sources listed. General information, not medical advice.

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How to check a periodontist's credentialsFour public records confirm a Florida periodontist's credentials: the Department of Health license search, the federal NPI Registry, the American Board of Periodontology locator and CODA's list of accredited residencies.

Questions to ask a periodontistPatients can ask a periodontist about training, the diagnosis, treatment options, time and visits, cost and insurance, sedation and aftercare before agreeing to a plan.

Sedation for gum and implant surgeryGum and implant surgery is done under local anesthesia, alone or with nitrous oxide, oral sedation, IV moderate sedation or general anesthesia.

Referrals to a periodontistA referral to a periodontist is required only when the dental plan requires one.

Second opinion on a periodontal planA second opinion is a separate evaluation of the diagnosis and plan by another periodontist, built on copies of the first office's x-rays, chart and coded plan.

Preparing for gum or implant surgeryPreparing for gum or implant surgery means a medication review with the prescribing physician, antibiotics only for patients who meet heart or joint criteria, fasting when sedation is planned, a ride home and soft food at home.