๐ฆท Welcome to The Clear Way: Dental Billing Decoded
๏ปฟ
๐ซCommon Billing Misconception

In the world of dental billing, certain codes cause more confusion than others, and D4355 is right at the top.
At Clear Way Dental Claims, we’ve helped hundreds of practices fix denied claims due to one major misconception: billing D4355 with a comprehensive exam on the same day.
Let’s clear the air and keep your claims clean, compliant, and paid.
๐งผ What is D4355?
D4355 is the Full Mouth Debridement to Enable a Comprehensive Oral Evaluation. It’s not a cleaning, and it’s not the same as scaling and root planing. It’s used when a patient’s oral condition specifically heavy plaque and calculus prevents the provider from performing a proper exam.
The ADA defines D4355 as a procedure that allows the dentist to see enough of the mouth to begin evaluation at a later visit.
๐ซ Common Misconception
“Can I bill D4355 with D0150?”
Short answer: No.
Long answer: D4355 cannot be billed with D0150, D0160, or D0180 on the same day. If a true comprehensive evaluation isn’t possible due to excessive debris, then billing a comprehensive exam on that date is incorrect and the claim will likely be denied.
โ Correct Billing Protocol
Day 1 - Patient presents with heavy calculus buildup:
- Bill D4355
- Use D0191 (limited assessment) if documentation is needed
- Document with clinical notes, radiographs, and intraoral photos
Day 2 - After debridement heals (typically 7–14 days later):
- Perform and bill D0150 or D0180 with proper diagnosis and charting
- Continue treatment planning or move to SRP if perio is diagnosed
๐งพ Tips for Claims Approval
- Use narratives: “Patient presented with significant plaque and calculus buildup that prevented accurate periodontal and dental charting. Debridement performed to enable comprehensive evaluation at a subsequent visit.”
- Attach photos and radiographs if available.
- Use correct frequency codes per plan policy (D4355 is often limited to once every 3–5 years).
๐ Final Thoughts
Misunderstanding how to bill D4355 can lead to claim denials, compliance issues, and reimbursement delays. When used correctly, this code supports accurate diagnoses and patient care.
Need a billing audit or coding refresher for your team? Clear Way Dental Claims has you covered. Let’s make every claim count.
References
American Dental Association. (2023). ADA guide to reporting D4355 – Full mouth debridement to enable a comprehensive oral evaluation. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/publications/cdt/v2_d4355adaguidetoreportingfullmouthdebridement_2023jan.pdf
American Dental Association. (2023). CDT 2023: Dental procedure codes. Chicago, IL: ADA Publishing.
RDH Magazine. (2022, December 19). D4355 undergoes major changes in CDT 2023. https://www.rdhmag.com/career-profession/insurance/article/14291329/d4355-undergoes-major-changes-in-cdt-2023
UnitedHealthcare. (2023). Dental coverage policy: Full mouth debridement. https://www.uhcprovider.com/content/dam/provider/docs/public/policies/dental/full-mouth-debridement.pdf

