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Scaling and root planing and generally accepted standards
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Anonymous26
medicine forum beginner


Joined: 21 Jul 2006
Posts: 1

PostPosted: Fri Jul 21, 2006 1:01 am    Post subject: Scaling and root planing and generally accepted standards Reply with quote

I had a four quadrant scaling and root planing performed by a general
dentist. Nine months and two weeks later, I was referred to a periodontist
by a different general dentist. I showed the periodontist documentation
showing my previous SRP. The periodontist recommended having the SRP again
in all four quadrants. He performed the SRP on my upper quadrants. This took
him five minutes. (I looked at my watch before and after the procedure.) On
another visit, his hygienist performed the SRP on my lower quadrants. This
took approximately five to seven minutes. In other words, the SRP took
approximately 10 to 12 minutes for all four quadrants.

The insurance company denied the SRP claim, stating that it only pays for
necessary work, in terms of generally accepted dental standards. My
insurance plan has no documented limitation for SRP procedures per year, so
the denial came as a surprise to the periodontist's billing staff member.
The insurance company will re-review the case based upon further
documentation from the periodontist and my prior charts. The bill for the
SRP is approximately $600. I would greatly appreciate insight from the
dentists here.

1. Are two SRP procedures ever clinically indicated within a one-year
period?
2. Can a four quadrant SRP be performed in 10 to 12 minutes with clinically
acceptable results?

Thank you very much for your input.
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Steven Bornfeld
medicine forum Guru


Joined: 28 Apr 2005
Posts: 492

PostPosted: Fri Jul 21, 2006 2:47 am    Post subject: Re: Scaling and root planing and generally accepted standards Reply with quote

Anonymous26 wrote:
Quote:
I had a four quadrant scaling and root planing performed by a general
dentist. Nine months and two weeks later, I was referred to a periodontist
by a different general dentist. I showed the periodontist documentation
showing my previous SRP. The periodontist recommended having the SRP again
in all four quadrants. He performed the SRP on my upper quadrants. This took
him five minutes. (I looked at my watch before and after the procedure.) On
another visit, his hygienist performed the SRP on my lower quadrants. This
took approximately five to seven minutes. In other words, the SRP took
approximately 10 to 12 minutes for all four quadrants.

The insurance company denied the SRP claim, stating that it only pays for
necessary work, in terms of generally accepted dental standards. My
insurance plan has no documented limitation for SRP procedures per year, so
the denial came as a surprise to the periodontist's billing staff member.
The insurance company will re-review the case based upon further
documentation from the periodontist and my prior charts. The bill for the
SRP is approximately $600. I would greatly appreciate insight from the
dentists here.

1. Are two SRP procedures ever clinically indicated within a one-year
period?

Certainly possible. But the need for root planing less than a year
later suggests inadequate healing (that is, residual periodontal
pockets), inadequate oral hygiene, or both.
It certainly wouldn't be unusual for an insurance company to deny
repeat SRP due to frequency limitations. However, if this is not the
case, my guess is that they may have pended the claim for x-rays,
periodontal charting, or both. If your dentist has supplied x-rays and
charting that don't show significant evidence of periodontal disease,
the insurance company certainly may choose to deny the claim based on
lack of clinical need.

Quote:
2. Can a four quadrant SRP be performed in 10 to 12 minutes with clinically
acceptable results?

Not by me, it can't.

Steve

Quote:

Thank you very much for your input.


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