CDT Code Updates 2015

Here at Hygiene Edge we thought you may be interested to find out some of the newest CDT code updates that are available out there for hygienists to use in our daily practice. I always recommend coding for the services you provide even if you don’t charge for them. 

D9931 Cleaning and Inspection of a Removable Appliance

            Have you ever had to clean a removable denture? Even after I have put the denture in the tartar cleaner and placed it in the ultrasonic for 15 minutes the calculus is usually still there.  If this is the case I will take my ultrasonic on a very low setting and scale off the remaining calculus (take the ultrasonic to the calc. only.) Now when I do this procedure I can add the proper code for the treatment completed. 

D1353 Sealant repair — Per Tooth

            Of course when my patients sit in the chair I am looking to see if the sealants that were placed at the last visit are preforming their duties properly. There have been a few times where I have found the need to give a little touch up. Now when I do this I have this code to utilize.

D4921- Gingival Irrigation

            This addition actually comes from the CDT 2014 updates. If you are putting an anti-microbial irrigation into pockets following root debridement you should use this code in your treatment plan. 

D1208- Fluoride (Excluding Varnish)

            If you are placing fluoride varnish use the code D1206 and if you are using any other type of fluoride application such as gels, foams, or swishes, then use D1208. 

While of course submitting a code to the dental insurance doesn’t mean you will get reimbursed, still code for the services you provide. This creates value to the patient as they look through their itemized walk out statement and they can see all of the services that were provided that day. 
 
                                                                                                                                                       -Shelley

Blood Pressure Guidelines for the Dental Hygienist

Happy Love Day, Hygiene Friends!

What better day than to talk about the heart and blood pressure than today? We know we all learned how to take blood pressure in school, and were required to take it also every appointment on our patients. Do you still follow that protocol your office? Though it does take an extra minute or two of an already packed appointment, the act of taking a patient’s blood pressure reading could be life saving. Most patients see their hygienist and dentist more often than their physician, so screening for blood pressure could change someone’s future.

So you have decided to start taking blood pressures at your office! Now what? Here is a quick chart for reference to know what is normal, and what to do if it isn’t.

Top Number (Systolic)     Bottom Number (Diastolic)     Category               
   in mm Hg                                     in mm Hg

Below 120                             Below 80               Normal Blood Pressure    

Recommendations: Maintain healthy lifestyle, Monitor annually

120-139                                   80-89                    Prehypertension                

Recommendations: Maintain or start living healthy lifestyle, Monitor at each appointment, limit epi

140-159                                   90-99                  Stage 1 Hypertension          

Recommendations: Refer patient to see  medical doctor, monitor at each appointment, limit epi


160 and Over                        100 and Over     Stage 2 Hypertension          

Recommendations: Defer treatment, refer to medical doctor and possibly ER, monitor at each appointment when under control, limit epi.

We love being in a profession that is live changing and life saving. We hope you do too!
 

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TIP: Use an automatic wrist blood pressure cuff like the one you see here.  It makes taking blood pressure quick and easy. Taking blood pressure is the standard of care now and your license could depend on it in case of an emergency.

Joint Pre-Medication Update from JADA

We are no longer required to pre-medicate for joint replacements. If your patients request this, refer them to their orthopedic surgeon for any pre-medication prescriptions, questions or concerns.  Here is a quote from the conclusion in the recent article in JADA.

"using antibiotics before dental procedures is not recommended to prevent Prostetic Joint Infections"

View the article in the link below
http://jada.ada.org/article/S0002-8177(14)00016-6/fulltext

Mandibular Cross Innervation-What Should I Do?

We have all been there before, as you approach #24/25 you are bracing yourself for the potential patient "jolt" as they experience pain from cross-innervation from the opposite quadrant. About 30% of the time I see this in practice so it is good to have a clear understanding of your options in this case. The video below gives a suggestion on how to deal with this situation. Other options are to hand instrument the area (instead of using the ultrasonic,) give a PDL injection, give a papillary injection or as a last resort give an IA in the opposite quadrant.