by Natalie Tornese | Last updated Mar 1, 2023 | Published on May 20, 2019 | Insurance Verification and Authorizations | 0 comments. Merck Manual Professional Version. The dentist will go along and beneath the gumline to remove plaque. A vibrating metal tip on the scaler chips tartar off of your teeth above your gum line. Coverage on periodontal scaling and root planing (SRP) Frequencies for denial are more with certain procedures such as periodontal scaling and root planing In addition to qualifying pocketing, radiographs must show loss of alveolar crest height beyond the normal 1-1.5mm distance to the cemento-enamel junction (CEJ). It may be done using instruments, a laser or an ultrasonic device. It is very important to contact the insurance company to determine the correct address, department and person to whom appeals should be sent. I am writing to appeal the denial of my claim number 789 for my root scaling procedure that was performed on September 3, 2013. I would appreciate a reconsideration of I have included copies of the following documents with this letter: I respectfully request that you reconsider your decision and cover the cost of the scaling and root planing procedure. It is also known as deep cleaning. Send your appeal letter to the specified department of the carrier and it must be in the form the carrier requires, Include the word appeal in the title and the text of the document and in any cover letter that accompanies the appeal document, D4341 periodontal scaling and root planing four or more teeth per quadrant, D4342 periodontal scaling and root planing one to three teeth per quadrant, D2950 core buildup, including any pins when required. WebScaling and root planing is a thorough dental cleaning of tooth root surfaces to remove plaque and tartar (calculus) from around teeth and periodontal pockets in the gums, and to smooth the teeth roots to remove bacterial toxins. Loralee joined MOS Revenue Cycle Management Division in October 2021. Delta Dental defines periodontal scaling and root planing (SRP) as a definitive non-surgical periodontal treatment involving the judicious and thorough planing of the root surface. The procedure involves instrumentation of the crown and root surfaces of the teeth to remove plaque and calculus. After removing plaque, your dentist will plane, or smooth out, the rough surfaces on the roots of your teeth. Dentistry-Informed Consent for Nitrous Oxide and Oxygen Conscious Sedation. The procedure will be covered with periodontal maintenance after scaling and root planing, when the patient has had sufficient time to heal and pocket depths are still 5mm or more. than the clinical need of the specific patient. All rights reserved. Save my name, email, and website in this browser for the next time I comment. Get Your Scaling and Root Planing Covered: Appeal Letter Tips Your gums may be temporarily swollen and tender after the procedure. However, youre expected to know the policy upon payment. These procedures provide effective antimicrobial therapy by
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