D1110 & D4910 – Avoid Common Dental Code Errors

December 14, 2023

Updated 04/2026

Every January, the dental world braces for new CDT codes, and in January 2026, another 31 are joining the 2026 CDT Code lineup. That means over 800 active codes your team needs to navigate flawlessly.

For most dental billers, it’s not just overwhelming–it’s exhausting. One coding slip can mean a denied claim, a confused patient, and lost revenue.

One of the most common culprits? Confusion about when to report D1110 (Adult Prophylaxis) and D4910 (Periodontal Maintenance). Whether you’re searching for the perio maintenance code, need to understand the D1110 dental code description, or want to know the difference between prophylaxis and periodontal maintenance, this guide covers the critical coding distinctions that prevent claim denials.

Quick Reference: Prophylaxis and Perio Maintenance Codes

CDT vs CPT Codes: Important Distinction

D1110 and D4910 are CDT codes (dental), not CPT codes (medical). If you’re searching for “CPT code D1110” or “CPT code D4910,” these procedures are reported using the Current Dental Terminology (CDT) code set published by the American Dental Association, not the Current Procedural Terminology (CPT) code set used for medical billing. Always use CDT codes for dental procedures when billing dental insurance. For comprehensive dental coding guidance, including all CDT code categories, see our complete CDT code library.

What is Dental Code D1110?

Removal of Local Irritational Factors

D1110 is the ADA code for adult prophylaxis. It is used to report the removal of local irritational factors for patients with mixed and permanent dentition. It is generally performed on patients with healthy gums and no history of periodontal disease; however, it is not a statement of health and may also be performed as an adjunct to periodontal maintenance (see the Q&A below).

Bill D1110 when:

• The patient has permanent teeth and no active periodontal disease.
• The visit is preventive, not therapeutic.
• The goal is to maintain oral health — not treat infection or inflammation.

If the patient has moderate to severe gingivitis with bleeding on probing on more than 30% of teeth and no bone loss, use Dental Code D4346 instead.

What is Dental Code D4910?

The Lifelong Fight Against Periodontal Disease

D4910 is the perio maintenance code, and it’s not a standard cleaning. It’s a therapeutic procedure; maintenance therapy for patients who’ve already undergone treatment for periodontal disease. It’s defined by the ADA as:

“This procedure is instituted following periodontal therapy and continues at varying intervals, determined by the clinical evaluation of the dentist, for the life of the dentition or an implant replacement. It includes removal of the bacterial plaque and calculus from supragingival and subgingival regions, site specific scaling and root planing where indicated, and polishing the teeth. If new or recurring periodontal disease appears, additional diagnostic and treatment procedures must be considered.”

Bill D4910 when:

• The patient has had scaling and root planing (SRP) or osseous surgery.
• You perform prophylaxis plus selective scaling and root planing, where indicated.
• You’re maintaining the results of prior periodontal therapy.

While the ADA states that maintenance should continue “for life,” insurers often limit the number or duration of covered visits, so verify plan details every time. Include dates and treated quadrants of previous periodontal procedures in the narrative.

Maximize reimbursement with a narrative:

“If benefits are not available for D4910, please pay the alternate benefit of D1110.”

That way, you report the correct procedure and still help the patient maximize their benefits.

Get the Help Your Practice Deserves

At eAssist, our team of Success Consultants understands the importance of CDT code accuracy and claim compliance. We help dental teams avoid coding errors, minimize denials, and collect what is rightfully owed. For comprehensive dental billing support including prophylaxis and periodontal maintenance coding, our team can help. Schedule a consultation and learn how eAssist can help your practice thrive.

Common D1110 and D4910 Coding Questions

Q: What is the difference between D1110 and D4910?
D1110 is a preventive prophylaxis for patients with healthy gums or as an adjunct to periodontal care. D4910 is therapeutic periodontal maintenance performed after scaling and root planing or periodontal surgery. The key difference: D1110 is preventive, D4910 is therapeutic maintenance following active periodontal treatment.

Q: If D4341 or D4342 is done on two or more quadrants, does that mean D4910 should be coded moving forward? What if SRP was done on fewer than two quadrants? Should we stick with D1110?
Excellent question, and one that trips up many practices. While some payors won’t reimburse D4910 after treating just one quadrant, or even two D4342 quadrants, remember this golden rule: Always code for what you do – not what you think will get reimbursed. If the procedure meets all D4910 clinical criteria, it should be coded as such. That includes polishing, supragingival and subgingival plaque/calculus removal, and site-specific SRP as needed. If only a few isolated sites were treated, D1110 prophylaxis might be more appropriate. There’s nothing in CDT language that prevents its use; it’s up to the clinician’s judgment.

Q: If a patient has had SRP, does that mean future hygiene treatments are limited only to D4910?
While D4910 periodontal maintenance is appropriate for a patient who has had SRP or perio surgery “for the life of the dentition and any implant replacements,” that does NOT mean they can never have a prophylaxis again. A prophylaxis is NOT A STATEMENT OF HEALTH. Per the 2026 ADA Coding Companion: “There is nothing in the codes’ D4910, D1110, or D1120 nomenclatures or descriptors that makes these procedures mutually exclusive. If the dentist determines that the patient’s periodontal health can be augmented with periodic routine prophylaxis procedures (removal of plaque, calculus, and stains from the tooth structures for the purpose of controlling local irritational factors), then this service should be performed and reported as D1110 or D1120, depending on the state of the dentition.” While prophylaxis is not therapeutic (does not treat disease), it may still be used as a supplement or adjunct to therapeutic treatments. That said, if you perform subgingival scaling and site-specific SRP, you should report D4910 regardless of insurance reimbursement. You may, however, include a narrative that states, “If benefits are exhausted for D4910, please pay the alternate benefit of D1110.” That way, you still “code for what you do,” but may still receive some reimbursement if allowed by the plan document language.

Q: What is the perio maintenance code?
D4910 is the periodontal maintenance code used after a patient has completed active periodontal therapy (scaling and root planing or periodontal surgery). It is a therapeutic procedure, not a preventive prophylaxis.

Q: Can I alternate between D1110 and D4910?
Yes, but only when clinically appropriate. If the patient’s periodontal health has improved to the point where only prophylaxis is needed (no subgingival scaling or site-specific SRP), D1110 may be appropriate. However, if you’re performing therapeutic maintenance with subgingival instrumentation, D4910 is the correct code. Always code for what you do clinically, not based on insurance coverage cycles.

Q: What is the ADA code for prophylaxis?
D1110 is the ADA/CDT code for adult prophylaxis (removal of plaque, calculus, and stains from tooth structures). For child prophylaxis, use D1120.

Q: Do D1110 and D4910 have frequency limitations?
Frequency limitations vary by payor. Many plans cover D1110 twice per year and D4910 up to four times per year, but this varies. Some plans apply combined frequency limits (e.g., two cleanings total regardless of code). Always verify benefits before scheduling to avoid patient surprise bills.

Q: What documentation is required for D4910?
Include a narrative with dates and quadrants of previous periodontal therapy (SRP or surgery), current periodontal health assessment, and notation of any site-specific scaling and root planing performed during the maintenance visit. This supports medical necessity and proper code selection.

Q: What is D4346 and when do I use it instead of D1110 or D4910?
D4346 (scaling in presence of generalized moderate or severe gingival inflammation) is used when the patient has moderate to severe gingivitis with bleeding on probing on more than 30% of teeth but no bone loss. It’s a therapeutic procedure, not preventive. For complete D4346 billing guidance, including documentation requirements and coverage tips, see our dedicated D4346 guide.

Disclaimer: Insurance administration and dental billing recommendations presented here represent the opinions of the author or our staff and are for informational purposes only. You are responsible for your own use of the CDT Codes, insurance administration, and dental billing. For the latest CDT codes and official interpretations, contact the American Dental Association or visit ADA.org.