It's unethical to diagnose a treatment plan and diagnose periodontal disease without probing depths. Even if it were a scaling and root planing treatment plan, you can not diagnose without probing depths, regardless if calculus is present on x rays. This office wanted to charge for a 4 quad scaling and root planing when pocket depts were within normal limits on 3 quadrants. We got a second opinion and he only needed one quadrant srp on 3 teeth. Just because calculus is present on x rays, doesn't mean you can over diagnose. Insurance won't pay for a scaling and root planing procedure with pocket depths within normal range.