Coding with Kyle: D5994—Periodontal medicament carrier with peripheral seal, laboratory processed

D5994—Periodontal medicament carrier with peripheral seal, laboratory processed

The purpose of D5994: Perio Protect is a prescribed medical device used to treat patients who suffer from periodontal disease. The device is lab-created and used as a “tray” to deliver peroxide into a patient’s periodontal pockets. There are many variables involved when it comes to dental insurance coverage and reimbursement.

•  Periodontal case type should be indicated on the claim form to inform the insurance processor what type of disease exists.

•  Describing the medicament carrier device as “perio protect” is not enough to ensure insurance plan coverage.

•  Submitting a clear written narrative that explains the benefits of the medical device and outlining the treatment plan with desired prognosis can help facilitate approval in some cases.

•  Providing x-rays, narrative, recent periodontal charting, and photographs will ensure a smooth

claim approval or denial and alleviate the need to submit additional information to the insurance company at a later date.