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Medical Forum / General / Dentistry / July 2006Scaling and root planing and generally accepted standards
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. > 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 [quoted text clipped - 17 lines] > 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. > 2. Can a four quadrant SRP be performed in 10 to 12 minutes with clinically > acceptable results? Not by me, it can't. Steve > Thank you very much for your input. > > 2. Can a four quadrant SRP be performed in 10 to 12 minutes with clinically > > acceptable results? > > Not by me, it can't. > > Steve Steve is always a gentleman...I'll go out on a limb and say not by anyone. If they took 12 minutes to do 4 quads of scaling and root planing, they didn't really do 4 quads of scaling and root planing. Most offices will take anywhere from 20 minutes to 40 minutes per quad. T > Steve is always a gentleman...I'll go out on a limb and say not by anyone. > If they took 12 minutes to do 4 quads of scaling and root planing, they > didn't really do 4 quads of scaling and root planing. Most offices will take > anywhere from 20 minutes to 40 minutes per quad. > > T The mail is in the check. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > 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 [quoted text clipped - 17 lines] > 1. Are two SRP procedures ever clinically indicated within a one-year > period? Possibly yes, if the problem has not improved after the first treatment. Most periodontists cite research that indicates the original SRP needs to be followed with visits every three months for light scaling and cleaning. Without the three-month recall visits, there is a tendency for the results of the original SRP to be less than optimal. If you have not kept up with the three-month visits for followup scaling, it would not be a surprise to find that conditions have reverted to their original state. Also, the thoroughness of daily oral hygiene procedures (brushing, flossing, use of interdental cleaners like perio brushes, etc.) will have a very large influence on whether the healing is adequate. > 2. Can a four quadrant SRP be performed in 10 to 12 minutes with clinically > acceptable results? You've got to be kidding. Most periodontists spend more than that amount of time just to do the 3-month recall scalings, on all four quadrants, at a fraction of that cost. > Thank you very much for your input. You're welcome. - dentaldoc You are suffering from shysteritis that is overtaking the denta industry. C'Mon guys ..... be honest with the dude -- Joel34 |
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