Thanks For Asking

By: Kathy Edwards, RDH, Margaret Boyce-Cooley and Dana Morano of the Practice Support Team

Burkhart’s Practice Support Team provides support to doctors by answering hundreds of questions that come in through our toll-free number and email. It is our pleasure to provide answers and resources—at no fee—to all of our Burkhart clients. Consider it a value-added service from Burkhart. We’ve compiled the most frequently asked questions and shared some insight on those here.

How do we appropriately use the ADA’s newly approved scaling code, D4346, which went into effect January 1, 2017?
The new scaling code will provide an alternative to D1110 for patients exhibiting inflammation in the absence of attachment loss. The CDT defines this as “scaling in presence of generalized moderate or severe gingival inflammation—full mouth, after oral evaluation. The removal of plaque, calculus and stains from supra- and sub-gingival tooth surfaces when there is generalized moderate or severe gingival inflammation in the absence of periodontitis. It is indicated for patients who have swollen, inflamed gingiva, generalized suprabony pockets, and moderate to severe bleeding on probing. It should not be reported in conjunction with prophylaxis, scaling and root planning, or debridement procedures.”

This ADA easy-to-understand flow chart can be used to help guide practitioners in selecting the appropriate code for their patients’ care:

Why was a new scaling code added to the CDT code?
Previous CDT codes did not address therapeutic treatment for patients with generalized, moderate to severe gingival inflammation. D4346 fills this gap. It is the ADA’s objective to provide a code that will result in more accurate documentation and reporting by eliminating “undercoding” as a D1110 (prophy) and “overcoding” as scaling and root planning. It will also help to eliminate the use of D4999 as this code requires a narrative and inhibits auto adjudication.

Additional information, including commonly asked questions and answers regarding D4346, can be accessed by emailing the Practice Support Team ( or on the ADA’s website,


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