New Grad Unsure about Perio Treatment Plan
New grad associate dentist in need of help. I'm confused with what perio tx to provide with this patient:
51F with history of SRP (2 rounds; the first was 8 years ago, the second was 5 years ago) presents for their 3 month Perio Maintenance recall with generalized (gen) 4-5mm pockets and CAL (~1mm increase (for both pocket depth and CAL) from their last visit a little less than 2 years ago when the owner doc decided to keep pt on Perio Maintenance), gen mild (but stable since last visit) ~2mm horizontal bone loss, gen light-moderate bleeding on probing, gen moderate-heavy plaque, gen light supragingival calculus (localized moderate-heavy on lingual of mandibular anteriors), localized light-moderate subgingival calculus (3 out of 30 teeth; radiographically visible on BWs/PAs). Patient is a daily smoker. No significant medical history, not on any medications.
My hygienist recommended re-doing 4 full quads SRP due to the gen 5mm pocket depths, but I thought that was a little overkill because of the visibly stable radiographic Bone Levels and the fact that subgingival calculus was radiographically visible on only 3 teeth. My thought process was: no change in bone level=not active periodontitis, backed up by the lack of visible subg calculus in all but 3 teeth. I've also read somewhere that the Perio Maintenance code D4910 includes localized SRP if needed?
Would greatly appreciate any input on what treatment to code out in this situation.