Dental Consultant Advice: D4910

The industry standard for periodontal procedures is between 30-35% of hygiene production. Periodontal maintenance (D4910), of course, follows SRPs. It is not preventive. It is after-care. 

However sometimes patients are billed for a prophy (D1110) when in fact what they got was a D4910 or some other after-care treatment. If this is happening in your practice there is likely a significant loss of production.

Sometimes this occurs as that’s the “way it’s always been done” or because the hygienist and/or front desk person do not know how to comfortably explain the differences in the treatments so they opt for the path of least resistance as they are afraid they will upset or lose the patient.

For this reason it is vital that your hygienist and front desk be able to comfortably educate the patient on the necessity of regular periodontal maintenance visits and how that is different from a prophy. This is done using effective case presentation techniques. Start by role playing with your hygienists to see how well they can educate patients on the differences. It can be a real eye opener.

Also putting a hygienist on production based pay is one way to get hygienists to be more aware of what treatment a patient should be getting but if your hygienist wants hourly pay then you might consider implementing a bonus based on a percentage over 3X her pay. However do not expect such a system to work unless the hygienist is already a willing producer as bonus systems rarely have a positive effect on clock punchers. However if the hygienist is not comfortable explaining the differences in treatment such a system will fail so the first step is to role play to see how competent or not the hygienist is at educating patients and then take it from there. You might also find that some hygienists will complain about doing too many SRPs. In my opinion the only scheduling issue a hygienist should be concerned about are open hours though I would avoid scheduling back to back SRPs when possible.