Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

D4320 - D4381  Non-Surgical Periodontal Services

D4320
Provisional splinting-intracoronal
shortProvision splnt intracoronal
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
D4321
Provisional splinting-extracoronal
shortProvisional splint extracoro
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
D4341
Periodontal scaling and root planing - four or more teeth per quadrant
shortPeriodontal scaling & root
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
D4342
Periodontal scaling and root planing - one to three teeth, per quadrant
shortPeriodontal scaling 1-3teeth
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
D4346
Scaling in presence of generalized moderate or severe gingival inflammation - full mouth, after oral evaluation
shortScaling gingiv inflammation
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
D4355
Full mouth debridement to enable a comprehensive oral evaluation and diagnosis on a subsequent visit
shortFull mouth debridement
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0YYY
MUE
LocationValueAjudication IndicatorRationale
PRA1.02 Date of Service Edit: PolicyCode Descriptor / CPT Instruction
OPH1.02 Date of Service Edit: PolicyCode Descriptor / CPT Instruction
D4381
Localized delivery of antimicrobial agents via controlled release vehicle into diseased crevicular tissue, per tooth
shortLocalized delivery antimicro
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0YYY
MUE
LocationValueAjudication IndicatorRationale
PRA12.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
OPH12.03 Date of Service Edit: ClinicalClinical: CMS Workgroup