Avoid undercoding with this brief refresher

Dental code 1110

 

The D1110 dental code represents adult prophylaxis, a preventive procedure where you remove plaque, calculus (tartar), and superficial stains from tooth surfaces in the permanent and transitional dentition. It is aimed at controlling local irritants and supporting periodontal health in patients who are generally periodontally healthy.

You typically use D1110 for patients with healthy gums or mild, localized gingivitis without significant inflammation, clinical attachment loss, or bone loss. In most practices, it is the code behind the “routine cleaning” patients receive at their recall visits, often every six months. To use D1110 appropriately, your documentation should reflect relatively healthy periodontal tissues, with charting, radiographs, and clinical notes that support a preventive, not therapeutic, level of care.

Benefits of using the D1110 code in your dental practice

When you apply D1110 correctly, you support accurate clinical records, smoother insurance processes, clearer care pathways, and stable preventive revenue. It also helps distinguish routine maintenance from gingivitis or periodontal therapy, which protects both patient outcomes and reimbursement.

Accurate documentation for preventive care

D1110 allows you to accurately document routine prophylaxis for adult patients who are maintaining good oral health. Using this code signals that:

  • The patient has permanent or mixed dentition.
  • Periodontal tissues are generally healthy or show only mild, localized gingival inflammation.
  • The visit is focused on supragingival and limited subgingival deposit and stain removal as part of ongoing maintenance.

When your notes describe deposits, bleeding points, pocket depths, and risk factors, D1110 becomes a precise reflection of preventive care, instead of a generic label for any type of “cleaning.”

Streamlined insurance claims

Because D1110 is universally recognized as a preventive prophylaxis code, using it appropriately can help streamline claim submission. Many dental plans:

  • Classify D1110 as a preventive service.
  • Cover it at a relatively high percentage compared with basic or major services.
  • Apply specific frequency limits per year or benefit period.

Clear clinical documentation and correct code selection reduce the likelihood of recodes, denials, or requests for additional information. You still need to verify each patient’s benefits, but accurate coding minimizes administrative rework for your team.

Better patient care categorization

Correctly distinguishing between D1110 and therapeutic codes helps you create a clear continuum of care. In particular, it helps you separate:

  • Patients appropriate for routine prophylaxis (D1110).
  • Patients with generalized moderate or severe gingival inflammation without attachment loss, who may require gingivitis treatment such as D4346.
  • Patients with bone loss and clinical attachment loss, who require scaling and root planing.

This categorization improves communication with patients about their periodontal status and supports treatment plans that are truly aligned with disease severity, rather than defaulting everything to a “cleaning.”

Enhanced revenue and practice efficiency

Prophylaxis visits are a cornerstone of your hygiene schedule and overall production. When you reserve D1110 for appropriate cases and use therapeutic codes for disease management, you:

  • Align production with the complexity of care delivered.
  • Avoid undercoding periodontal or gingivitis therapy as simple prophylaxis.
  • Reduce downcoding and claim adjustments by payers.
  • Limit time spent on claim corrections, appeals, and back-and-forth with insurers.

Clear coding protocols, team calibration on periodontal diagnosis, and standardized charting all help your practice maintain consistent preventive revenue while supporting timely escalation to therapeutic care when indicated.

FAQs

How often can I bill D1110?

You should bill D1110 whenever you deliver an adult prophylaxis that is clinically indicated and supported by your findings, regardless of how often the patient’s plan will pay. Many plans allow D1110 once or twice per year as a preventive benefit, but frequency limits and other rules vary by payer and policy.

Does dental insurance cover D1110?

In most dental benefit plans, D1110 is categorized as a preventive service and is often covered at a higher percentage than basic or major restorative procedures. Coverage, however, depends on the specific contract and may be subject to frequency limits, waiting periods, and annual maximums.

What is the difference between D1110 and D1120?

D1110 is used for adult prophylaxis in patients with permanent or mixed dentition. D1120 is used for child prophylaxis in patients with primary or mixed dentition. The key distinction in CDT terminology is dentition type rather than age, though many benefit plans layer age-based limitations on top of the CDT definitions.