SRP 4+ teeth billed, only 2 teeth qualify

Claim 20000 · Acme Dental Mutual · Date of service 09/15/2026 · Source: synthetic case srp-02-too-few-teeth · Generated 2026-10-12 07:10 UTC

Prepare in Open Dental

Needs documentation

Not ready: 1 item to fix in the chart before this claim goes out. Re-run ClaimClear afterwards.

To-do list as an Open Dental task

ClaimClear: claim 20000 (date of service 09/15/2026), documentation is missing.

D4341 periodontal scaling and root planing, four or more teeth per quadrant, the lower right quadrant:
- Verify the charting or change the code to D4342.

Open Dental API call

POST /tasks
{
  "TaskListNum": 1,
  "UserNum": 1,
  "Descript": "ClaimClear: claim 20000 (date of service 09/15/2026), documentation is missing.\n\nD4341 periodontal scaling and root planing, four or more teeth per quadrant, the lower right quadrant:\n- Verify the charting or change the code to D4342.",
  "KeyNum": 20000,
  "ObjectType": "Patient"
}

Claim tracking status

ClaimClear: documentation missing, see task

Open Dental API call

POST /claimtrackings
{
  "ClaimNum": 20000,
  "TrackingDefNum": 2,
  "Note": "ClaimClear: documentation missing, see task"
}

ClaimClear never sends claims. After approving, staff attach the narrative PDF and radiographs to the claim in Open Dental and send it as usual.

D4341 periodontal scaling and root planing, four or more teeth per quadrant · the lower right quadrant · 09/15/2026

Needs documentation

Do this before submitting

Verify the charting or change the code to D4342.

Narrative Every sentence checked against the chart

Diagnosis: generalized Stage III Grade B periodontitis. Full-mouth periodontal charting was recorded 07/21/2026. Generalized horizontal bone loss noted on FMX. Heavy subgingival calculus LR. Bitewing radiographs taken 05/26/2026. Treatment: D4341 periodontal scaling and root planing, four or more teeth per quadrant on the lower right quadrant, date of service 09/15/2026.

373 characters

Claim note

SRP LR: perio chart, radiographs, narrative attached

Attachments

Item	Status	Detail
Periodontal chart	In Open Dental	Full-mouth periodontal charting was recorded 07/21/2026. Source: Perio Chart exam dated 07/21/2026 (PerioExamNum 20301).
Radiograph	In Open Dental	Bitewing radiographs taken 05/26/2026. Source: Open Dental Imaging: "4BWX" (X-Rays), DocNum 20201.

Documentation checks (Default (common plan guidelines - verify per carrier))

Check	Status	Detail
Periodontal charting within 12 months	Met	Full-mouth periodontal charting was recorded 07/21/2026.
4+ teeth in the quadrant with pockets of 4 mm or more	Missing	Only 2 teeth in the lower right quadrant probe 4 mm or deeper; D4341 requires 4 or more. The 1-3 teeth code (D4342) may be correct.
Radiograph of the lower right quadrant within 24 months	Met	Bitewing radiographs taken 05/26/2026 (3.7 months before the date of service).
Periodontal diagnosis documented (recommended)	Met	Diagnosis: generalized Stage III Grade B periodontitis.
Radiographic bone loss documented (recommended)	Met	Generalized horizontal bone loss noted on FMX.

Evidence used (7 facts)

ID	Fact	Where it comes from
C1	D4341 periodontal scaling and root planing, four or more teeth per quadrant on the lower right quadrant, date of service 09/15/2026.	Procedure D4341 (ProcNum 20001)
C2	Bitewing radiographs taken 05/26/2026.	Open Dental Imaging: "4BWX" (X-Rays), DocNum 20201
C3	Full-mouth periodontal charting was recorded 07/21/2026.	Perio Chart exam dated 07/21/2026 (PerioExamNum 20301)
C4	Lower right quadrant on the 07/21/2026 charting: 2 teeth with probing depths of 4 mm or more (#28: 5 mm, #29: 4 mm). Bleeding on probing at 4 sites.	Perio Chart exam dated 07/21/2026, LR quadrant
N1	Diagnosis: generalized Stage III Grade B periodontitis. "Dx: generalized Stage III Grade B periodontitis"	Clinical note: D4341 LR on 09/15/2026 (this procedure)
N2	Generalized horizontal bone loss noted on FMX. "Generalized horizontal bone loss noted on FMX"	Clinical note: D4341 LR on 09/15/2026 (this procedure)
N3	Heavy subgingival calculus LR. "Heavy subgingival calculus LR"	Clinical note: D4341 LR on 09/15/2026 (this procedure)

Draft → check → revise loop (1 iteration)

Iteration 1: no issues

Clinical notes read (1, names redacted)

D4341 LR on 09/15/2026 (this procedure)

Dx: generalized Stage III Grade B periodontitis. Generalized horizontal bone loss noted on FMX. Heavy subgingival calculus LR. Scaling and root planing LR quad, 2 carpules lidocaine. Pt tolerated well.

Engine: extractor heuristic, narrator template, reviewer none.